1093929291 NPI number — CHER, LLC

Table of content: (NPI 1093929291)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093929291 NPI number — CHER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHER, 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:
6
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:
1093929291
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/18/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8610 EXPLORER DR
Provider Second Line Business Mailing Address:
300
Provider Business Mailing Address City Name:
COLORADO SPRINGS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80920-1058
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-955-4140
Provider Business Mailing Address Fax Number:
719-955-4148

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3601 S PEARL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ENGLEWOOD
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80113-3805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-762-0060
Provider Business Practice Location Address Fax Number:
303-762-1131
Provider Enumeration Date:
05/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
JONES
Authorized Official First Name:
JEFF
Authorized Official Middle Name:
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
719-955-4332

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QR0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 73830399 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: CEC62914 . This is a "BCBS COLORADO" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: P00677733 . This is a "RR MEDICARE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 62914 . This is a "BCBS FEDERAL COLORADO" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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