1659858447 NPI number — ENVISION HOSPICE OF COLORADO LLC

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 1659858447 NPI number — ENVISION HOSPICE OF COLORADO LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ENVISION HOSPICE OF COLORADO 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:
ENVISION HEALTHCARE AT HOME
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:
1659858447
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/03/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1345 W 1600 N STE 202
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OREM
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84057-2431
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7150 CAMPUS DR STE 330
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLORADO SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80920-3180
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-596-5001
Provider Business Practice Location Address Fax Number:
719-596-5003
Provider Enumeration Date:
07/24/2018

Additional Information

Authorized Official

Authorized Official Last Name:
STEWART
Authorized Official First Name:
SHERIE
Authorized Official Middle Name:
Authorized Official Title or Position:
COO/MANAGER
Authorized Official Telephone Number:
801-225-7971

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  17C439 , 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)





Copyright © 2007-2024 www.npivalidator.com