NPIMap

Organization Active NPI

Marillac Clinic, Inc Dba Primehealth

Doing business as PrimeHealthplus

  • Federally Qualified Health Center (FQHC)
  • Grand Junction, CO
National Provider Identifier
1801530928
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MARILLAC CLINIC, INC DBA PRIMEHEALTH
Doing business as
PrimeHealthplus
Practice address
2139 N 12TH St Ste 2
Grand Junction, CO 81501-2910
Phone
(970) 200-1600
Fax
(970) 692-8301
NPI assigned
Apr 25, 2022
Last updated
Sep 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lata Ramachandran
Title
Ceo
Phone
(970) 200-1600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

2139 N 12TH St Ste 2
Grand Junction, CO 81501-2910

Mailing address

526 29 1/2 Rd
Grand Junction, CO 81504-5383

Other names 1

  • PrimeHealthplus Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2286306Marillac Clinic, Inc2139 N 12TH Street Ste 2, Grand Junction, CO 81501Provider-performed microscopyJul 25, 2027

National Provider Directory

National Provider Directory
Tax ID family
Marillac Clinic Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2139 N 12th St
Grand Junction, CO 81501
Phone (970) 256-8449

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1650844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789948800000",
    "number": "1801530928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 29 1/2 RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815045383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2139 N 12TH ST STE 2",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815012910",
            "telephone_number": "970-200-1600",
            "fax_number": "970-692-8301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARILLAC CLINIC, INC DBA PRIMEHEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-25",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A",
        "authorized_official_last_name": "RAMACHANDRAN",
        "authorized_official_first_name": "LATA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "970-200-1600"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PrimeHealthplus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.