| Penrose Family Health Clinic | |
|
91 Illinois St Penrose CO 81240-9683 | |
| (719) 372-6555 | |
| Not Available |
| Full Name | Penrose Family Health Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 91 Illinois St, Penrose, Colorado |
| Authorized Official Name and Position | Madeleine Jacobs (SOLE PROPRIETOR) |
| Authorized Official Contact | 7193726555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Penrose Family Health Clinic 91 Illinois St Penrose CO 81240-9683 Ph: (719) 372-6555 | Penrose Family Health Clinic 91 Illinois St Penrose CO 81240-9683 Ph: (719) 372-6555 |
| NPI Number | 1578910790 |
|---|---|
| Provider Enumeration Date | 05/17/2016 |
| Last Update Date | 05/17/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578910790 | NPI | - | NPPES |
| 01271006 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 27100 (Colorado) | Primary |