1316988413 NPI number — DENVER HEALTH AND HOSPITAL AUTHORITY

Table of content: (NPI 1316988413)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316988413 NPI number — DENVER HEALTH AND HOSPITAL AUTHORITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DENVER HEALTH AND HOSPITAL AUTHORITY
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:
LOWRY FAMILY HEALTH 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:
1316988413
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/02/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
777 BANNOCK ST # MC1925
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:
80204-4507
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-436-6000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1001 YOSEMITE ST
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:
80230-6003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-436-4545
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BURNETTE
Authorized Official First Name:
PEG
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF REVENUE OFFICER
Authorized Official Telephone Number:
303-602-6739

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X , with the licence number:  0900 , 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: 05638598 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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