Provider Demographics
NPI:1336166420
Name:FAMILY HEALTH CARE OF THE ROCKIES
Entity type:Organization
Organization Name:FAMILY HEALTH CARE OF THE ROCKIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-266-8822
Mailing Address - Street 1:3000 S COLLEGE AVE
Mailing Address - Street 2:STE 210
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-2558
Mailing Address - Country:US
Mailing Address - Phone:970-266-8822
Mailing Address - Fax:970-266-8833
Practice Address - Street 1:3000 S COLLEGE AVE
Practice Address - Street 2:STE 210
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-2558
Practice Address - Country:US
Practice Address - Phone:970-266-8822
Practice Address - Fax:970-266-8833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC530198Medicare PIN