| Marillac Clinic, Inc. | |
|
3150 N 12th St Grand Junction CO 81506 | |
| (970) 298-1782 | |
| (970) 298-1711 |
| Full Name | Marillac Clinic, Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 3150 N 12th St, Grand Junction, Colorado |
| Authorized Official Name and Position | Lata Ramachandran (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9702982235 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Marillac Clinic, Inc. 2333 N 6th St Grand Junction CO 81501-2001 Ph: (970) 298-1782 | Marillac Clinic, Inc. 3150 N 12th St Grand Junction CO 81506 Ph: (970) 298-1782 |
| NPI Number | 1063861748 |
|---|---|
| Provider Enumeration Date | 06/03/2016 |
| Last Update Date | 09/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063861748 | NPI | - | NPPES |
| 15522865 | Medicaid | CO | |
| 90252365 | Medicaid | CO | |
| 27421767 | Medicaid | CO | |
| 38402068 | Medicaid | CO | |
| 72071362 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 18U295 (Colorado) | Primary |
Western Slope Geriatrics, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2754 Compass Dr, #170, Grand Junction, CO 81506 Phone: 303-912-7064 | |
Grand Junction Family Medicine Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 525 North Ave, Suite 104, Grand Junction, CO 81501 Phone: 970-424-5030 | |
Internal Medicine Associates Of The Grand Valley Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 607 28 1/4 Rd, Grand Junction, CO 81506 Phone: 970-243-3300 | |
Hopewest Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3090 N 12th St Unit B, Grand Junction, CO 81506 Phone: 970-241-2212 Fax: 970-257-2401 | |
Aspen Grove Family Practice, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3096 I-70 Business Loop, Unit D, Grand Junction, CO 81504 Phone: 970-314-2805 Fax: 970-314-7919 | |
St. Mary's Family Medicine Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2698 Patterson Rd Unit 42, Grand Junction, CO 81506 Phone: 970-298-2800 Fax: 970-298-6902 |