1265687966 NPI number — CHILDREN'S HOSPITAL COLORADO

Table of content: (NPI 1265687966)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265687966 NPI number — CHILDREN'S HOSPITAL COLORADO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHILDREN'S HOSPITAL COLORADO
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:
CHILDREN'S HOSPITAL COLORADO - AUDIOLOGY
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:
1265687966
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/02/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13123 E. 16TH AVENUE
Provider Second Line Business Mailing Address:
BOX 030
Provider Business Mailing Address City Name:
AURORA
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80045-7160
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
720-777-6800
Provider Business Mailing Address Fax Number:
720-777-7299

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13123 E 16TH AVE
Provider Second Line Business Practice Location Address:
BOX 030
Provider Business Practice Location Address City Name:
AURORA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80045-7106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-777-6800
Provider Business Practice Location Address Fax Number:
720-777-7299
Provider Enumeration Date:
11/21/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MICHAEL
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
Authorized Official Title or Position:
VP, CHIEF COMPLIANCE OFFICER
Authorized Official Telephone Number:
720-934-5053

Provider Taxonomy Codes

  • Taxonomy code: 282NC2000X , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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