MARILLAC CLINIC, INC. (NPI# 1093345886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093345886 |
| Entity Type | Organization |
| Organization Name | MARILLAC CLINIC, INC. |
| Practice Address |
550 Warrior Way Grand Junction CO 81504-6401 |
| Mailing Address |
2333 N 6th St Grand Junction CO 81501-2001 |
| Practice Telephone | 9702981782 |
| Practice Fax Number | 9706928301 |
| Enumeration Date | 2020-01-21 |
| Last Update Date | 2020-01-21 |
| Authorized Official Name | LATA RAMACHANDRAN (CEO) |
| Authorized Official Telephone | 9702982235 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497103212 | Marillac Clinic, Inc. | Clinic/Center | 2853 North Ave, Grand Junction, CO 81501 | 2016-06-02 |
| 1093163800 | Marillac Clinic, Inc. | Clinic/Center | 302 Pitkin Ave, Grand Junction, CO 81501 | 2016-06-02 |
| 1063861748 | Marillac Clinic, Inc. | Clinic/Center | 3150 N 12th St, Grand Junction, CO 81506 | 2016-06-03 |
| 1871865576 | Marillac Clinic, Inc. | Optometrist | 2333 N 6th St, Grand Junction, CO 81501 | 2012-01-27 |
| 1518239219 | Marillac Clinic, Inc. | Physician Assistant | 2333 N 6th St, Grand Junction, CO 81501 | 2012-01-27 |
| Street Address |
550 WARRIOR WAY |
| City | GRAND JUNCTION |
| State | CO |
| Zip Code | 81504-6401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699226936 | Ariel Kristine Rendt Padron | Counselor | 639 Long Peak Ct, Grand Junction, CO 81504 | 2016-10-21 |
| 1902197460 | Bereket Yebiyo | Pharmacist | 2992 F Rd., Grand Junction, CO 81504 | 2011-05-02 |
| 1467636787 | Renae Tabin | Physician Assistant | 569 32 Rd Ste 12, Grand Junction, CO 81504 | 2007-12-21 |
| 1689892069 | Mark Newhouse | Physical Therapist | 2777 Crossroads Blvd, Grand Junction, CO 81504 | 2007-04-23 |
| 1841414570 | Deborah Ann Didonato | Registered Nurse | 510 29 .5 Rd, Grand Junction, CO 81504 | 2007-04-12 |
| 1073634952 | Darilynn Sue Maddux | Technician | 510 29.5, Grand Junction, CO 81504 | 2007-04-02 |
| 1538289749 | Shirley Callaway | Registered Nurse | 510 29. 5 Road, Grand Junction, CO 81504 | 2007-03-30 |
| 1407891328 | Dillon Companies LLC | Durable Medical Equipment & Medical Supplies | 569 32 Rd, Grand Junction, CO 81504 | 2006-06-17 |
| 1275536146 | Mesa County Health Department | Registered Nurse | 510 29 1/2 Road, Grand Junction, CO 81504 | 2005-05-24 |
| 1104275882 | Marillac Clinic, Inc | Clinic/Center | 510 29 1/2 Rd, Grand Junction, CO 81504 | 2016-06-03 |
| Find all providers in zip 81504 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497103212 | Marillac Clinic, Inc. | Clinic/Center | 2853 North Ave, Grand Junction, CO 81501 | 2016-06-02 |
| 1063861748 | Marillac Clinic, Inc. | Clinic/Center | 3150 N 12th St, Grand Junction, CO 81506 | 2016-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972118073 | Sunrise Community Health | Clinic/Center | 2880 Monroe Ave, Loveland, CO 80538-3274 | 2020-09-15 |
| 1538772892 | Valley-wide Health Systems, Inc. | Clinic/Center | 204 Carson Ave, Alamosa, CO 81101-2342 | 2020-08-26 |
| 1225640931 | Valley-wide Health Systems, Inc. | Clinic/Center | 1215 Main St Ste B, Canon City, CO 81212-3505 | 2020-08-24 |
| 1568073229 | Mountain Family Health Centers | Clinic/Center | 2270 Highway 133, Carbondale, CO 81623-9271 | 2020-08-14 |
| 1912515735 | Peak Vista Community Health Centers | Clinic/Center | 423 E Cucharras St Ste 2, Colorado Springs, CO 80903-3609 | 2020-07-17 |
| 1861014805 | Metro Community Provider Network, Inc. | Clinic/Center | 3595 S Teller St Fl 4, Lakewood, CO 80235-2014 | 2020-05-13 |
| 1548897648 | Plan De Salud Del Valle, Inc | Clinic/Center | 709 E Riverview Ave # 201, Fort Morgan, CO 80701-3263 | 2020-03-26 |
| 1134766553 | Plan De Salud Del Valle, Inc | Clinic/Center | 562 Sable Blvd Ste 100, Aurora, CO 80011-0809 | 2019-12-04 |
| 1033755392 | Metro Community Provider Network, Inc. | Clinic/Center | 12055 W 2nd Pl # 200, Lakewood, CO 80228-1506 | 2019-11-21 |
| 1639714041 | Peak Vista Community Health Centers | Clinic/Center | 4041 E San Miguel St, Colorado Springs, CO 80909 | 2019-11-08 |
| Find all providers with the same taxonomy | ||||
| City | GRAND JUNCTION |
| Zip Code | 81504 |
Please comment or provide details below to improve the information on MARILLAC CLINIC, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.