MEDICARE: MESA COUNTY VALLEY SCHOOL DISTRICT #51

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
1	251300000X	Local Education Agency (LEA)		CO

General Provider Information

NPI Number	:	1518183086
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MESA COUNTY VALLEY SCHOOL DISTRICT #51

Provider Business Mailing Address
First Line	:	410 HILL AVE
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81501-2528
Country	:	US
Telephone Number	:	970-254-5405
Fax Number	:	970-245-0825

Provider Business Practice Location Address
First Line	:	410 HILL AVE
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81501-2528
Country	:	US
Telephone Number	:	970-254-5405
Fax Number	:	970-245-0825

Authorized Official
Title or Position	:	D & E CLINIC COORDINATOR
Name	:	MR. JOHN E DROGOS
Credential	:	MSW
Telephone Number	:	970-254-5405

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	08/22/2020

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