MARILLAC CLINIC, INC. – NPI #1780399154
Clinic/Center

MARILLAC CLINIC, INC. is an AHC clinic located in GRAND JUNCTION, CO. NPPES has assigned the NPI number 1780399154 to MARILLAC CLINIC, INC. on January 19, 2023. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MARILLAC CLINIC, INC. below.

NPI Profile for
MARILLAC CLINIC, INC.

NPI Number
1780399154
Enumeration Date

(more than 3 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MARILLAC CLINIC, INC.
Primary location
360 W PARK DR
GRAND JUNCTION, CO 81505-1618
Phone: (970) 200-1600 Fax: (970) 692-8301
Mailing address
2333 N 6TH ST
GRAND JUNCTION, CO 81501-2001
Phone: (970) 200-1600 Fax:
Organization Subpart
No
Authorized Official
LATA RAMACHANDRAN
CEO
Phone: (970) 200-1600
Updated
Certification Date
Jan 19, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.