1457501728 NPI number — MILE HIGH CORNEAL SPECIALISTS PC

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 1457501728 NPI number — MILE HIGH CORNEAL SPECIALISTS PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MILE HIGH CORNEAL SPECIALISTS PC
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:
1457501728
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/12/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3535 RIVER POINT PKWY STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHERIDAN
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80110-3325
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-482-1300
Provider Business Mailing Address Fax Number:
303-482-1356

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3535 RIVER POINT PARKWAY
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
SHERIDAN
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80110-8011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-482-1300
Provider Business Practice Location Address Fax Number:
303-482-1356
Provider Enumeration Date:
09/23/2008

Additional Information

Authorized Official

Authorized Official Last Name:
RICHHEIMER
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
303-482-1300

Provider Taxonomy Codes

  • Taxonomy code: 261QS0132X , with the licence number:  44960 , 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: 1457501728 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1518464247 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1073175337 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1477715829 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1821663295 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1043716269 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1376583575 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1407426091 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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