Front Range Clinic Inc.

LBN: Front Range Clinic Inc.
Front Range Clinic Inc. is an health care organization with primary practice located at 1308 Vivian St , Longmont CO 80501-3217. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Addiction Medicine is the primary health care specialty. Front Range Clinic Inc. can be contacted via phone (303) 834-8809, or through Mccoy, Clark via phone (352) 214-7180.

Contact Information

Primary practice address
1308 Vivian St Longmont CO 80501-3217
Phone: (303) 834-8809
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Mccoy, Clark Doctor of Medicine (MD)
Phone: (352) 214-7180

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0054001 Colorado
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X 0054001 Colorado

Profile Details

NPI number 1104342443
LBN Legal business name Front Range Clinic Inc.
DBA Doing business as
Authorized official Mccoy, Clark Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 18th, 2017
Last updated Dec 17th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104342443 NPPES
Colorado MEDICAID 1598135451

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