1245876721 NPI number — PLANNED PARENTHOOD OF THE ROCKY MOUNTAINS

Table of content: (NPI 1245876721)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245876721 NPI number — PLANNED PARENTHOOD OF THE ROCKY MOUNTAINS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PLANNED PARENTHOOD OF THE ROCKY MOUNTAINS
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:
1245876721
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/12/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
719 SAN MATEO BLVD NE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALBUQUERQUE
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
87108-1434
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-485-0464
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1284 S ABILENE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AURORA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80012-4629
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-671-7526
Provider Business Practice Location Address Fax Number:
303-671-7544
Provider Enumeration Date:
11/20/2019

Additional Information

Authorized Official

Authorized Official Last Name:
HERRERA
Authorized Official First Name:
MARISSA
Authorized Official Middle Name:
Authorized Official Title or Position:
CREDENTIALING SPECIALIST
Authorized Official Telephone Number:
505-944-2021

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QA0005X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 4927083 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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