1437417078 NPI number — ESTRELLA HOME HEALTH CARE INC.

Table of content: JAMES HENRY BRYNIARSKI D.D.S. (NPI 1568402766)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437417078 NPI number — ESTRELLA HOME HEALTH CARE INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ESTRELLA HOME HEALTH CARE INC.
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:
1437417078
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/21/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4155 E JEWELL AVE STE 816
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:
80222-4519
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-756-6756
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4155 E JEWELL AVE STE 816
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:
80222-4519
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-756-6756
Provider Business Practice Location Address Fax Number:
303-756-1189
Provider Enumeration Date:
05/02/2012

Additional Information

Authorized Official

Authorized Official Last Name:
AKINS
Authorized Official First Name:
WENDEL
Authorized Official Middle Name:
ADRAIN
Authorized Official Title or Position:
BUSINESS DEVELOPMENT
Authorized Official Telephone Number:
623-792-7282

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , 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: 70053065 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 33080577 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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