MEDICARE: MONTROSE WOMENS HEALTH CARE, PC, INC.

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	207VG0400X	Gynecology Physician	453168	CO

General Provider Information

NPI Number	:	1699757450
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONTROSE WOMENS HEALTH CARE, PC, INC.

Provider Business Mailing Address
First Line	:	904 SOUTH 4TH STREET
Second Line	:
City	:	MONTROSE
State	:	CO
Zip	:	81401-4226
Country	:	US
Telephone Number	:	970-252-3450
Fax Number	:	970-252-3454

Provider Business Practice Location Address
First Line	:	904 SOUTH 4TH STREET
Second Line	:
City	:	MONTROSE
State	:	CO
Zip	:	81401-4226
Country	:	US
Telephone Number	:	970-252-3450
Fax Number	:	970-252-3454

Authorized Official
Title or Position	:	CORPORATE SECRETARY
Name	:	JAMES H GARRARD
Credential	:
Telephone Number	:	303-545-5525

Provider Enumeration Date	:	11/17/2005
Last Update Date	:	01/07/2008

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