Provider Demographics
NPI:1649031162
Name:WEST SLOPE MEDICAL SERVICES LLC-S
Entity type:Organization
Organization Name:WEST SLOPE MEDICAL SERVICES LLC-S
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACKLYN
Authorized Official - Middle Name:SPRY
Authorized Official - Last Name:HARDIN
Authorized Official - Suffix:
Authorized Official - Credentials:FNPC
Authorized Official - Phone:970-596-6486
Mailing Address - Street 1:1404 HAWK PKWY UNIT 201
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-6470
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2731 COMMERCIAL WAY UNIT AB
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-5700
Practice Address - Country:US
Practice Address - Phone:970-398-4720
Practice Address - Fax:970-650-8165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty