1770738650 NPI number — ASL-DEN LLC

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 1770738650 NPI number — ASL-DEN LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASL-DEN LLC
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:
1770738650
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/03/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
658 GRASSMERE PARK STE 104
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37211-3683
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-916-3200
Provider Business Mailing Address Fax Number:
615-916-3218

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6116 E WARREN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80222-5703
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-512-2216
Provider Business Practice Location Address Fax Number:
303-692-6061
Provider Enumeration Date:
11/19/2008

Additional Information

Authorized Official

Authorized Official Last Name:
PAPAIOANU
Authorized Official First Name:
ATHANASSIOS
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT & CEO
Authorized Official Telephone Number:
615-916-3200

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  800026147 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 291U00000X , with the licence number: 2125 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 291U00000X , with the licence number: 06D0512826 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 445399 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100300880 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0145662-00 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1770738650 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1770738650 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2040427 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200239440A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1770738650 , issued by the state of ( NV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 58200878 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10025736500 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1770738650 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1770738650 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1770738650 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1770738650 , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200601720A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 210087709 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 88509761 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 127960200 , issued by the state of ( WY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1770738650 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 014566200 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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