1588766968 NPI number — REGENTS OF THE UNIVERSITY OF COLORADO

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 1588766968 NPI number — REGENTS OF THE UNIVERSITY OF COLORADO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REGENTS OF THE UNIVERSITY OF 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:
UCHSC HEMOPHILIA CENTER
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:
1588766968
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13199 EAST MONTVIEW BOULEVARD
Provider Second Line Business Mailing Address:
#100
Provider Business Mailing Address City Name:
AURORA
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80045
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-724-0168
Provider Business Mailing Address Fax Number:
303-724-0848

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13199 EAST MONTVIEW BOULEVARD
Provider Second Line Business Practice Location Address:
#100
Provider Business Practice Location Address City Name:
AURORA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80045
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-724-0168
Provider Business Practice Location Address Fax Number:
303-724-0848
Provider Enumeration Date:
09/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PRIMEAUX
Authorized Official First Name:
JUDITH
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PHARMACY DIRECTOR
Authorized Official Telephone Number:
303-724-0167

Provider Taxonomy Codes

  • Taxonomy code: 3336S0011X , with the licence number:  990000050 , 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)

  • Identifier: 03002862 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 614621 . This is a "NCPDP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 990000050 . This is a "COLORADO PHARMACY LICENSE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 0614621 . This is a "WYOMING PHARMACY LICENSE" identifier , issued by the state of ( WY ) . This identifiers is of the category "OTHER".
  • Identifier: 107812702 , issued by the state of ( WY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0000211692 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1545 . This is a "MONTANA PHARMACY LICENSE" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 4115 . This is a "ARIZONA PHARMACY LICENSE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 94 . This is a "NEBRASKA PHARMACY LICENSE" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".




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