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NPI Code Detail

MEDICARE: FREMONT COUNTY

MEDICARE: FREMONT COUNTY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management Agency09000225CO
2343900000XNon-emergency Medical Transport (VAN)06200224CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366593196
Entity Type Code : Organization
Provider Name (Legal Business Name) : FREMONT COUNTY
Provider Business Mailing Address
First Line : 172 JUSTICE CENTER RD
Second Line :
City : CANON CITY
State : CO
Zip : 81212-9354
Country : US
Telephone Number : 719-275-2318
Fax Number : 719-275-5206
Provider Business Practice Location Address
First Line : 172 JUSTICE CENTER RD
Second Line :
City : CANON CITY
State : CO
Zip : 81212-9354
Country : US
Telephone Number : 719-275-2318
Fax Number : 719-275-5206
Authorized Official
Title or Position : DIRECTOR
Name : MR. STEVEN A CLIFTON
Credential :
Telephone Number : 719-275-2318
Provider Enumeration Date : 01/16/2007
Last Update Date : 09/11/2025

Similar Medicare Providers

1568629301 — MS. LAURIE LEE WERTZBAUGHER RN
Practice Location Address:
172 JUSTICE CENTER RD
CANON CITY, CO
81212-9354
Practice Phone: 719-275-1626
Practice Fax: 719-275-4328
1164689998 — PAULA JEAN WHITEHORN REGISTERED NURSE
Practice Location Address:
172 JUSTICE CENTER RD
CANON CITY, CO
81212-9354
Practice Phone: 719-275-1626
Practice Fax: 719-275-4328
1568629921 — CLAUDIA J SANTEE R.N.
Practice Location Address:
172 JUSTICE CENTER RD
CANON CITY, CO
81212-9354
Practice Phone: 719-275-1626
Practice Fax:
1659666865 — JOANIE AMBA DOCKINS RN
Practice Location Address:
172 JUSTICE CENTER RD
CANON CITY, CO
81212-9354
Practice Phone: 719-275-1626
Practice Fax: 719-275-4328
1477848554 — SHELLY BROOKS RN
Practice Location Address:
172 JUSTICE CENTER RD
CANON CITY, CO
81212-9354
Practice Phone: 719-275-1626
Practice Fax: 719-275-4328
1427343557 — LINDA KAY UHLAND RN
Practice Location Address:
172 JUSTICE CENTER RD
CANON CITY, CO
81212-9354
Practice Phone: 719-275-1626
Practice Fax: 719-275-4328

Directions to “FREMONT COUNTY ” Practice Location

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