1427744945 NPI number — TFL PROVIDER NETWORK LLC

Table of content: MS. JENNIFER ALICIA CLARK RPH (NPI 1447260898)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427744945 NPI number — TFL PROVIDER NETWORK LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TFL PROVIDER NETWORK 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:
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:
1427744945
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/17/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3996 RED CEDAR DR UNIT A6
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HIGHLANDS RANCH
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80126-8066
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-800-2829
Provider Business Mailing Address Fax Number:
720-408-0320

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6900 E LAYTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80237-3616
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-800-2829
Provider Business Practice Location Address Fax Number:
720-408-0320
Provider Enumeration Date:
04/17/2023

Additional Information

Authorized Official

Authorized Official Last Name:
OSTER
Authorized Official First Name:
MATT
Authorized Official Middle Name:
Authorized Official Title or Position:
CO OWNER
Authorized Official Telephone Number:
303-800-2829

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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