1467571406 NPI number — COLORADO HEALTHCARE SUPPORT, INC DBA PARKER & CASTLE ROCK CENTER FOR A

Table of content: (NPI 1467571406)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467571406 NPI number — COLORADO HEALTHCARE SUPPORT, INC DBA PARKER & CASTLE ROCK CENTER FOR A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COLORADO HEALTHCARE SUPPORT, INC DBA PARKER & CASTLE ROCK CENTER FOR A
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:
CASTLE ROCK CENTER FOR AUDIOLOGY
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:
1467571406
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/19/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
62 FOUNDERS PKWY
Provider Second Line Business Mailing Address:
STE C-2
Provider Business Mailing Address City Name:
CASTLE ROCK
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80104
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-814-1725
Provider Business Mailing Address Fax Number:
303-814-9594

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11211 S DRANSFELDT RD
Provider Second Line Business Practice Location Address:
STE 133
Provider Business Practice Location Address City Name:
PARKER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80134
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-841-8818
Provider Business Practice Location Address Fax Number:
303-841-5088
Provider Enumeration Date:
03/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BAKER
Authorized Official First Name:
LINDA
Authorized Official Middle Name:
D
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
303-841-8818

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  104118 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 231H00000X , with the licence number: AUD72 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 237600000X , with the licence number: AUD72 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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