Russell J Meyerhofer, CAC II | |
3470 Baltimore Ave, Pueblo, CO 81008-1520 | |
(719) 562-0024 | |
Not Available |
Full Name | Russell J Meyerhofer |
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Gender | Male |
Speciality | Counselor - Addiction (substance Use Disorder) |
Location | 3470 Baltimore Ave, Pueblo, Colorado |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1215148671 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | 6303 (Colorado) | Primary |
Entity Name | Doctor On Demand Professionals P C |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1174931448 PECOS PAC ID: 9436464567 Enrollment ID: O20230929002930 |
Mailing Address | Practice Location Address |
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Russell J Meyerhofer, CAC II 3470 Baltimore Ave, Pueblo, CO 81008-1520 Ph: () - | Russell J Meyerhofer, CAC II 3470 Baltimore Ave, Pueblo, CO 81008-1520 Ph: (719) 562-0024 |
Mr. Darren Mitchell Speier, BS CAC II Counselor Medicare: Not Enrolled in Medicare Practice Location: 509 E 13th St, Pueblo, CO 81001 Phone: 719-546-6666 Fax: 719-543-7764 | |
Penelope Hyland, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1026 W Abriendo Ave, Pueblo, CO 81004 Phone: 719-545-2746 Fax: 719-545-4100 | |
Melissa Mahan Hall, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1026 W Abriendo Ave, Pueblo, CO 81004 Phone: 719-545-2746 Fax: 719-545-4100 | |
Jaycob Gonzales-cordova, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1302 Chinook Ln, Pueblo, CO 81001 Phone: 719-545-2746 Fax: 719-423-1882 | |
James Ryan Hall, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1304 Chinook Ln, Pueblo, CO 81001 Phone: 719-545-2746 Fax: 719-584-0110 | |
Felicia Gray, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1591 Taos Rd, Pueblo, CO 81006 Phone: 719-545-2746 | |
Stanley Schleifer, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1304 Chinook Ln, Pueblo, CO 81001 Phone: 719-545-2746 Fax: 719-584-0119 |