Organization
GOOD SAMARITAN CLINIC OF WESTERN COLORADO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELAINE TAYLOR RN (EXECUTUVE DIRECTOR)
(970) 290-1552
Entity
Organization
Contact information
Practice address
402 GRAND AVE, GRAND JUNCTION, CO 81501-2534
(970) 712-6518
Mailing address
402 GRAND AVE, GRAND JUNCTION, CO 81501-2534
(970) 712-6518
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FC0340
FTCA FREE CLINIC
—
Enumeration date
02/13/2018
Last updated
02/13/2018
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