1376181974 NPI number — NATIONAL JEWISH NORTHERN HEMOTOLOGY ONCOLOGY

Table of content: (NPI 1376181974)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376181974 NPI number — NATIONAL JEWISH NORTHERN HEMOTOLOGY ONCOLOGY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATIONAL JEWISH NORTHERN HEMOTOLOGY ONCOLOGY
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:
NATIONAL JEWISH NORTH
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:
1376181974
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/08/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1400 JACKSON ST
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:
80206-2762
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-388-4461
Provider Business Mailing Address Fax Number:
303-398-1211

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9451 HURON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
THORNTON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80260-5426
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-650-4042
Provider Business Practice Location Address Fax Number:
303-650-4046
Provider Enumeration Date:
12/13/2019

Additional Information

Authorized Official

Authorized Official Last Name:
MEDINA
Authorized Official First Name:
VICKI
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAL STAFF SERVICES
Authorized Official Telephone Number:
303-388-4461

Provider Taxonomy Codes

  • Taxonomy code: 261QX0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1326015777 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1376181974 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9000180262 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 04001905 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com