MEDICARE: FAMILY CENTERED MEDICINE, 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	208D00000X	General Practice Physician

Other Identifiers

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

General Provider Information

NPI Number	:	1972773232
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY CENTERED MEDICINE, INC

Provider Business Mailing Address
First Line	:	2121 S ONEIDA ST STE 248
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80224-2551
Country	:	US
Telephone Number	:	303-504-0600
Fax Number	:

Provider Business Practice Location Address
First Line	:	2121 S ONEIDA ST STE 248
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80224-2551
Country	:	US
Telephone Number	:	303-504-0600
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. PETER THOMAS PRUTCH
Credential	:	NP
Telephone Number	:	303-504-0600

Provider Enumeration Date	:	03/03/2008
Last Update Date	:	03/03/2008

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Directions to “FAMILY CENTERED MEDICINE, INC ” Practice Location

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