1154094894 NPI number — CRITICAL CARE PULMONARY AND SLEEP ASSOCIATES PROFESSIONAL LLP

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 1154094894 NPI number — CRITICAL CARE PULMONARY AND SLEEP ASSOCIATES PROFESSIONAL LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CRITICAL CARE PULMONARY AND SLEEP ASSOCIATES PROFESSIONAL LLP
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:
1154094894
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/06/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
274 UNION BLVD STE 110
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAKEWOOD
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80228-1836
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-951-0600
Provider Business Mailing Address Fax Number:
303-951-0605

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2030 MOUNTAIN VIEW AVE STE 310
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LONGMONT
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80501-3181
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-951-0600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/28/2021

Additional Information

Authorized Official

Authorized Official Last Name:
DENNEN
Authorized Official First Name:
PAULA
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
303-951-0600

Provider Taxonomy Codes

  • Taxonomy code: 207RC0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 04594040 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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