1154357176 NPI number — WESTMED PRIMARY CARE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154357176 NPI number — WESTMED PRIMARY CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WESTMED PRIMARY CARE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WESTMED FAMILY HEALTHCARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154357176
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/25/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12201 PECOS ST
Provider Second Line Business Mailing Address:
SUITE 500
Provider Business Mailing Address City Name:
WESTMINSTER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80234-3888
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-457-4497
Provider Business Mailing Address Fax Number:
303-450-4692

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12201 PECOS ST
Provider Second Line Business Practice Location Address:
SUITE 500
Provider Business Practice Location Address City Name:
WESTMINSTER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80234-3888
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-457-4497
Provider Business Practice Location Address Fax Number:
303-450-4692
Provider Enumeration Date:
06/23/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ANDERSON
Authorized Official First Name:
LORI
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRACTICE PRACTICE
Authorized Official Telephone Number:
303-450-4691

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CD8572 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".