Organization
BIG SKY MEDICINE PC
Active
Other names
Urgent Care Evergreen
Organization subpart
No
Provider details
NPI number
Authorized official
MARY SULLI (GENERAL MANAGER)
(303) 674-2273
Entity
Organization
Contact information
Practice address
1520 EVERGREEN PKWY, EVERGREEN, CO 80439-7848
(303) 674-2273
(303) 670-2160
Mailing address
PO BOX 1926, EVERGREEN, CO 80437-1926
(303) 674-2273
(303) 670-2160
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
73387738
—
CO
01
—
BI642581
BLUE SHIELD
CO
01
—
CK7854
RAILROAD MEDICARE
CO
Enumeration date
05/15/2006
Last updated
12/03/2008
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