1336361096 NPI number — DENVER ENDOCRINOLOGY, DIABETES AND THYROID CENTER, PC

Table of content: (NPI 1336361096)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336361096 NPI number — DENVER ENDOCRINOLOGY, DIABETES AND THYROID CENTER, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DENVER ENDOCRINOLOGY, DIABETES AND THYROID CENTER, PC
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:
Provider Other Organization Name Type Code:
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:
1336361096
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/02/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 E HAMPDEN AVE
Provider Second Line Business Mailing Address:
SUITE 560
Provider Business Mailing Address City Name:
ENGLEWOOD
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80113-3781
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-321-2644
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
799 E HAMPDEN AVE STE 525
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ENGLEWOOD
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80113-2786
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-321-2644
Provider Business Practice Location Address Fax Number:
303-321-2446
Provider Enumeration Date:
05/03/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GERARD
Authorized Official First Name:
LORI
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
303-321-2644

Provider Taxonomy Codes

  • Taxonomy code: 261QM2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 41235240 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: DN6181 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: DED41674 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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