Sangre De Cristo Family Practice Assoc., P.C.

LBN: Sangre De Cristo Family Practice Assoc., P.C.
Sangre De Cristo Family Practice Assoc., P.C. is an health care organization with primary practice located at 712 Macon Ave , Canon City CO 81212-3314. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Sangre De Cristo Family Practice Assoc., P.C. can be contacted via phone (719) 275-8646, or through Banker, Michael Wayne via phone (719) 275-8646.

Contact Information

Primary practice address
712 Macon Ave Canon City CO 81212-3314
Phone: (719) 275-8646
Fax: (888) 484-0223
Website:
Map and Directions
Authorized official contact:
Name: Banker, Michael Wayne Doctor of Medicine (MD)
Phone: (719) 275-8646

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X 27050 Colorado

Profile Details

NPI number 1962536326
LBN Legal business name Sangre De Cristo Family Practice Assoc., P.C.
DBA Doing business as
Authorized official Banker, Michael Wayne Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 15th, 2007
Last updated Jan 5th, 2016 - about 8 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 1962536326 NPPES
Colorado MEDICAID 04119046

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