1538305495 NPI number — PVMC PHYSICIAN SERVICES, INC

Table of content: (NPI 1538305495)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538305495 NPI number — PVMC PHYSICIAN SERVICES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PVMC PHYSICIAN SERVICES, INC
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:
TURNBERRY PLATTE VALLEY CENTER FOR WOMEN
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:
1538305495
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/06/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1606 PRAIRIE CENTER PKWY
Provider Second Line Business Mailing Address:
SUITE 210
Provider Business Mailing Address City Name:
BRIGHTON
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80601-4004
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-287-0584
Provider Business Mailing Address Fax Number:
303-287-2564

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12253 E. 104TH PL.
Provider Second Line Business Practice Location Address:
UNIT 101
Provider Business Practice Location Address City Name:
COMMERCE CITY
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-287-0584
Provider Business Practice Location Address Fax Number:
303-287-2564
Provider Enumeration Date:
12/24/2008

Additional Information

Authorized Official

Authorized Official Last Name:
DUPPER
Authorized Official First Name:
HAROLD
Authorized Official Middle Name:
Authorized Official Title or Position:
SECRETARY OF CORPORATION
Authorized Official Telephone Number:
303-498-1601

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com