Basic Information
Provider Information
NPI: 1609443167
EntityType: 2
ReplacementNPI:  
OrganizationName: RAPID CARE
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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Mailing Information
Address1: 750 HOSPITAL LOOP
Address2:  
City: CRAIG
State: CO
PostalCode: 816258750
CountryCode: US
TelephoneNumber: 9708249411
FaxNumber:  
Practice Location
Address1: 2020 W VICTORY WAY
Address2:  
City: CRAIG
State: CO
PostalCode: 816253440
CountryCode: US
TelephoneNumber: 9708268300
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/04/2021
LastUpdateDate: 06/04/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: VELARDO
AuthorizedOfficialFirstName: KEITH
AuthorizedOfficialMiddleName: A
AuthorizedOfficialTitleorPosition: IT DIRECTOR
AuthorizedOfficialTelephone: 9708262183
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: THE MEMORIAL HOSPITAL
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/04/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QR1300X  Y Ambulatory Health Care FacilitiesClinic/CenterRural Health

No ID Information.


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