NPI 1891069019 · live from the CMS NPI Registry
Banner Health Physicians Colorado LLC
Clinic/Center, Multi-Specialty in Julesburg, CO. National Provider Identifier 1891069019, active.
NPI record
| NPI | 1891069019 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Clinic/Center, Multi-Specialty 261QM1300X |
| Practice location | 900 Cedar St, Julesburg, CO 80737 |
| Practice phone | 970-522-2264 |
| Mailing address | 1441 N 12th St, Phoenix, AZ 85006 |
| Enumerated | March 6, 2012 |
| Last updated | November 1, 2013 |
| Authorized official | Dennis Dahlen, Sr Vp Finance |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Acute Care Hospital | 282N00000X | — |
| Clinic/Center, Multi-Specialty primary | 261QM1300X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.