| Win Hbo | |
|
1460 E Valley Rd 104 Basalt CO 81621-8411 | |
| (970) 384-8447 | |
| (970) 384-8480 |
| Full Name | Win Hbo |
|---|---|
| Speciality | Clinic/Center |
| Location | 1460 E Valley Rd, Basalt, Colorado |
| Authorized Official Name and Position | Kirk Douglas Hartley (CLINICAL DIRECTOR) |
| Authorized Official Contact | 9709274950 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Win Hbo 1460 E Valley Rd 104 Basalt CO 81621-8411 Ph: (970) 927-4950 | Win Hbo 1460 E Valley Rd 104 Basalt CO 81621-8411 Ph: (970) 384-8447 |
| NPI Number | 1093945685 |
|---|---|
| Provider Enumeration Date | 07/17/2009 |
| Last Update Date | 12/13/2024 |
| Medicare PECOS PAC ID | 2365818192 |
|---|---|
| Medicare Enrollment ID | O20221020000075 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093945685 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | John Cleveland Hughes |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1700084233 PECOS PAC ID: 6507180387 Enrollment ID: I20150127001796 |
| Provider Name | Stephanie Christine Karozos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932586336 PECOS PAC ID: 7214243450 Enrollment ID: I20180629000130 |
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