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Contact Information

SAN JUAN SENTRY, LLC
659 TECH CENTER DR # B
DURANGO, CO81301-7758
 Phone: 970-259-4818
 Fax: 970-247-4161
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Taxi

344600000X
Indicates primary specialty

NPI Profile & details for SAN JUAN SENTRY, LLC

NPI Number 1205208089
LBN Legal business name SAN JUAN SENTRY, LLC
Authorized official EDWARD GILBERT - (MANAGING MEMBER)
Entity Organization
Organization subpart 1 Yes
Enumeration date 10/20/2015
Last updated 11/03/2021 - About 5 years ago
Identifiers
CO License # L14196
CO Medicaid 39335836
CO Medicaid 86203339
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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