Marillac Clinic, Inc.

LBN: Marillac Clinic, Inc.
Marillac Clinic, Inc. is an health care organization with primary practice located at 3150 N 12Th St , Grand Junction CO 81506. The organization recently has only one registered license in Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), which is considered as the primary health care specialty. Marillac Clinic, Inc. can be contacted via phone (970) 298-1782, or through Ramachandran, Lata via phone (970) 298-2235.

Contact Information

Primary practice address
3150 N 12Th St Grand Junction CO 81506
Phone: (970) 298-1782
Fax: (970) 298-1711
Website:
Map and Directions
Authorized official contact:
Name: Ramachandran, Lata
Phone: (970) 298-2235

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X 18U295 Colorado

Profile Details

NPI number 1063861748
LBN Legal business name Marillac Clinic, Inc.
DBA Doing business as
Authorized official Ramachandran, Lata
Entity Organization
Organization subpart 1 No
Enumeration date Jun 3rd, 2016
Last updated Sep 21st, 2020 - about 5 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 1063861748 NPPES
Colorado MEDICAID 15522865
Colorado MEDICAID 90252365
Colorado MEDICAID 27421767
Colorado MEDICAID 38402068
Colorado MEDICAID 72071362

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