1669420410 NPI number — TOTAL HEALTHCARE

Table of content: (NPI 1669420410)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669420410 NPI number — TOTAL HEALTHCARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOTAL HEALTHCARE
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:
PIKES PEAK CANCER SPECIALISTS
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:
1669420410
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/24/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
DEPARTMENT 1322
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80291-1322
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-486-5500
Provider Business Mailing Address Fax Number:
303-486-5501

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2222 N NEVADA AVE
Provider Second Line Business Practice Location Address:
STE 201
Provider Business Practice Location Address City Name:
COLORADO SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80907-6831
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-776-5454
Provider Business Practice Location Address Fax Number:
719-776-2516
Provider Enumeration Date:
05/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HANNA
Authorized Official First Name:
RAMY
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
303-804-8189

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 09470352 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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