Potomac Square Family Medicine, Llc
LBN: Potomac Square Family Medicine, Llc
Potomac Square Family Medicine, Llc is an health care organization with primary practice located at 4800 Baseline Rd Ste D106 , Boulder CO 80303-2643. The organization recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Ambulatory Health Care Facilities / Primary Care. Ambulatory Health Care Facilities / Primary Care is the primary health care specialty.
Potomac Square Family Medicine, Llc can be contacted via phone (303) 499-0176, or through Gluchacki, Stephanie via phone (508) 689-9706.
Contact Information
Primary practice address
4800 Baseline Rd Ste D106
Boulder CO 80303-2643
Phone: (303) 499-0176
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | ||
| Ambulatory Health Care Facilities / Primary Care | 261QP2300X |
Profile Details
| NPI number | 1861001554 |
|---|---|
| LBN Legal business name | Potomac Square Family Medicine, Llc |
| DBA Doing business as | |
| Authorized official | Gluchacki, Stephanie |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 28th, 2020 |
| Last updated | Apr 14th, 2022 - about 2 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 | 1861001554 | NPPES |
| Colorado | MEDICAID | 18903312 |
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