| North Fork Medical Clinic Pc | |
|
225 Minnesota Ave Paonia CO 81428 | |
| (970) 527-4103 | |
| (970) 527-5171 |
| Full Name | North Fork Medical Clinic Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 225 Minnesota Ave, Paonia, Colorado |
| Authorized Official Name and Position | Timothy C. Meilner (OWNER, AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 9705274103 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Fork Medical Clinic Pc Po Box 47 Paonia CO 81428-0047 Ph: (970) 527-4103 | North Fork Medical Clinic Pc 225 Minnesota Ave Paonia CO 81428 Ph: (970) 527-4103 |
| NPI Number | 1215050489 |
|---|---|
| Provider Enumeration Date | 04/10/2007 |
| Last Update Date | 03/08/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215050489 | NPI | - | NPPES |
| 17380863 | Medicaid | CO | |
| 187276700 | Other | DEPT OF LABOR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Brain Reintegration Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 225 Minnesota Ave, Paonia, CO 81428 Phone: 541-647-0644 |