| Banner Fort Collins Pcp, Llc | |
|
205 S Main St Ste B Longmont CO 80501-1714 | |
| (303) 772-6244 | |
| Not Available |
| Full Name | Banner Fort Collins Pcp, Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 205 S Main St Ste B, Longmont, Colorado |
| Authorized Official Name and Position | Shiva Birdi (CEO) |
| Authorized Official Contact | 6027474000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Banner Fort Collins Pcp, Llc 2901 N Central Ave Ste 160 Phoenix AZ 85012-2702 Ph: () - | Banner Fort Collins Pcp, Llc 205 S Main St Ste B Longmont CO 80501-1714 Ph: (303) 772-6244 |
| NPI Number | 1467242651 |
|---|---|
| Provider Enumeration Date | 05/09/2025 |
| Last Update Date | 05/23/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467242651 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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