1588766968 NPI number — REGENTS OF THE UNIVERSITY OF COLORADO

Table of content: (NPI 1588766968)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588766968 NPI number — REGENTS OF THE UNIVERSITY OF COLORADO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REGENTS OF THE UNIVERSITY OF COLORADO
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:
UCHSC HEMOPHILIA CENTER
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:
1588766968
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13199 EAST MONTVIEW BOULEVARD
Provider Second Line Business Mailing Address:
#100
Provider Business Mailing Address City Name:
AURORA
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80045
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-724-0168
Provider Business Mailing Address Fax Number:
303-724-0848

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13199 EAST MONTVIEW BOULEVARD
Provider Second Line Business Practice Location Address:
#100
Provider Business Practice Location Address City Name:
AURORA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80045
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-724-0168
Provider Business Practice Location Address Fax Number:
303-724-0848
Provider Enumeration Date:
09/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PRIMEAUX
Authorized Official First Name:
JUDITH
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PHARMACY DIRECTOR
Authorized Official Telephone Number:
303-724-0167

Provider Taxonomy Codes

  • Taxonomy code: 3336S0011X , with the licence number:  990000050 , 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: 03002862 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 614621 . This is a "NCPDP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 990000050 . This is a "COLORADO PHARMACY LICENSE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 0614621 . This is a "WYOMING PHARMACY LICENSE" identifier , issued by the state of ( WY ) . This identifiers is of the category "OTHER".
  • Identifier: 107812702 , issued by the state of ( WY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0000211692 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1545 . This is a "MONTANA PHARMACY LICENSE" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 4115 . This is a "ARIZONA PHARMACY LICENSE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 94 . This is a "NEBRASKA PHARMACY LICENSE" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".




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