Organization Name: | EATON FAMILY CARE |
NPI Number: | 1336177989 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DENNIS DAHLEN (SR VICE PRESIDENT FINANCE) |
Mailing Address: | 100 S Cherry Ave Unit 1 Eaton |
State: | CO US |
Postal Code: | 806158256 |
Phone Number: | 9704543838 |
Fax Number: | 9704541265 |
NPI Enumeration Date: | 06/30/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |