1770169963 NPI number — GALLUS MEDICAL SERVICES OF COLORADO

Table of content: GREGORY COLLINS M.D. (NPI 1609833748)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770169963 NPI number — GALLUS MEDICAL SERVICES OF COLORADO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GALLUS MEDICAL SERVICES 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:
Provider Other Organization Name Type Code:
Provider Other Last Name:
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NPI Number Information

NPI Number:
1770169963
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/19/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 S JACKSON ST STE 220
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80209-3134
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
720-501-2227
Provider Business Mailing Address Fax Number:
720-501-2237

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5920 S ESTES ST STE 150
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:
80123-8620
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-673-8910
Provider Business Practice Location Address Fax Number:
720-242-8656
Provider Enumeration Date:
03/19/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
EDGAR
Authorized Official First Name:
ANNETTE
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAL REIMBURSEMENT MANAGER
Authorized Official Telephone Number:
720-501-2227

Provider Taxonomy Codes

  • Taxonomy code: 103TP2701X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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