1194145656 NPI number — MILE HIGH WOUND AND HYPERBARIC MEDICINE PLLC

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 1194145656 NPI number — MILE HIGH WOUND AND HYPERBARIC MEDICINE PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MILE HIGH WOUND AND HYPERBARIC MEDICINE PLLC
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:
1194145656
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/23/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12065 W AUBURN DR
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:
80228-4765
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:
12065 W AUBURN DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAKEWOOD
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80228-4765
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-202-7433
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/23/2014

Additional Information

Authorized Official

Authorized Official Last Name:
COJANU
Authorized Official First Name:
NELU
Authorized Official Middle Name:
DANIEL
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
706-202-7433

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  0051390 , 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)

  • Identifier: 0051390 . This is a "LICENSURE - STATE OF COLORADO" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




Copyright © 2007-2026 www.npivalidator.com