National Provider Identifier Database

INTERMOUNTAIN MEDICAL GROUP GRAND JUNCTION LLC
Addiction Medicine


Contact Information

INTERMOUNTAIN MEDICAL GROUP GRAND JUNCTION, LLC
2643 PATTERSON RD STE 603
GRAND JUNCTION, CO81506-1937
Phone: 970-298-3801
Fax: 970-232-2660
Website:
Specialty Taxonomy Code
* Addiction Medicine 207QA0401X
Addiction (Substance Use Disorder) 103TA0400X

* Indicates primary specialty

NPI Profile & details for INTERMOUNTAIN MEDICAL GROUP GRAND JUNCTION, LLC

NPI Number 1093538837
Legal business name
LBN
INTERMOUNTAIN MEDICAL GROUP GRAND JUNCTION, LLC
Authorized official JON MCDANIEL - (VP FINANCE)
Entity Organization
Organization subpart Yes
Enumeration date 10/31/2024
Last updated 10/31/2024 - More than a year ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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