Marillac Clinic, Inc
LBN: Marillac Clinic, Inc
Marillac Clinic, Inc is an health care organization with primary practice located at 510 29 1/2 Rd , Grand Junction CO 81504. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Dental, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC). Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) is 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
510 29 1/2 Rd
Grand Junction CO 81504
Phone: (970) 298-1782
Fax: (970) 298-1711
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Dental | 261QD0000X | ||
| Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) | 261QF0400X | 18U295 | Colorado |
Profile Details
| NPI number | 1104275882 |
|---|---|
| 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104275882 | NPPES |
| Colorado | MEDICAID | 15522865 | |
| Colorado | MEDICAID | 27421767 | |
| Colorado | MEDICAID | 72071362 | |
| Colorado | MEDICAID | 90252365 | |
| Colorado | MEDICAID | 38402068 |
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