1598263535 NPI number — QUE PASA, LLC

Table of content: (NPI 1598263535)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598263535 NPI number — QUE PASA, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
QUE PASA, LLC
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:
1598263535
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/02/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6700 W DORADO DR UNIT 16
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LITTLETON
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80123-5174
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-726-2065
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6700 W DORADO DR UNIT 16
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LITTLETON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80123-5174
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-726-2065
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/24/2018

Additional Information

Authorized Official

Authorized Official Last Name:
BLAKELY
Authorized Official First Name:
CHRISTIANA
Authorized Official Middle Name:
S
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
303-726-2065

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 121164 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: PHPK1768249 . This is a "PHILADELPHIA INSURANCE CO" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com