1972555928 NPI number — COLORADO PERSONNEL RESOURCES INC

Table of content: PAIGE ERIN MORTIMER APRN (NPI 1235904970)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972555928 NPI number — COLORADO PERSONNEL RESOURCES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COLORADO PERSONNEL RESOURCES INC
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:
1972555928
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/04/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3000 S JAMAICA CT
Provider Second Line Business Mailing Address:
#140
Provider Business Mailing Address City Name:
AURORA
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80014
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-755-3201
Provider Business Mailing Address Fax Number:
303-755-3204

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3000 S JAMAICA CT
Provider Second Line Business Practice Location Address:
#140
Provider Business Practice Location Address City Name:
AURORA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-755-3201
Provider Business Practice Location Address Fax Number:
303-755-3204
Provider Enumeration Date:
05/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GRUBE
Authorized Official First Name:
AMI
Authorized Official Middle Name:
E
Authorized Official Title or Position:
DIRECTOR OF ADMINISTRATION
Authorized Official Telephone Number:
720-231-3233

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 79805841 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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