1477678092 NPI number — COLORADO PULMONARY ASSOCIATES, PC

Table of content: (NPI 1477678092)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477678092 NPI number — COLORADO PULMONARY ASSOCIATES, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COLORADO PULMONARY ASSOCIATES, 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:
1477678092
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/03/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1601 E. 19TH AVE
Provider Second Line Business Mailing Address:
SUITE 3100
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80218-1239
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-863-0300
Provider Business Mailing Address Fax Number:
303-863-7014

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1601 E. 19TH AVE
Provider Second Line Business Practice Location Address:
SUITE 3100
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80218-1239
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-863-0300
Provider Business Practice Location Address Fax Number:
303-863-7014
Provider Enumeration Date:
03/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SCHWARTZ
Authorized Official First Name:
JEFFREY
Authorized Official Middle Name:
S.
Authorized Official Title or Position:
PRESIDENT, M.D.
Authorized Official Telephone Number:
303-863-0300

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 04012134 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com