Organization
MT CARMEL PRIMARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTY HERDER (CREDENTIALING MANAGER)
(303) 386-2727
Entity
Organization
Contact information
Practice address
911 ROBINSON AVE, TRINIDAD, CO 81082-2811
(719) 845-4800
(866) 712-1013
Mailing address
911 ROBINSON AVE, TRINIDAD, CO 81082-2811
(719) 845-4800
(866) 712-1013
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
30427
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81030258
—
CO
Enumeration date
06/09/2014
Last updated
04/10/2017
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