1336239532 NPI number — HEALTHONE CLINIC SERVICES 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 1336239532 NPI number — HEALTHONE CLINIC SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTHONE CLINIC SERVICES 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:
6
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:
1336239532
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
720 S COLORADO BLVD
Provider Second Line Business Mailing Address:
SUITE 220A
Provider Business Mailing Address City Name:
GLENDALE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80246-1912
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-584-8231
Provider Business Mailing Address Fax Number:
866-210-0907

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1721 E 19TH AVE
Provider Second Line Business Practice Location Address:
SUITE 244
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80218-1251
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-831-9853
Provider Business Practice Location Address Fax Number:
303-861-4741
Provider Enumeration Date:
10/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KING
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
E
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
303-584-8231

Provider Taxonomy Codes

  • Taxonomy code: 2080P0214X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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