1497806632 NPI number — WESTCARE INC

Table of content: (NPI 1497806632)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497806632 NPI number — WESTCARE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WESTCARE INC
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:
1497806632
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/31/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8811 AMERICAN WAY STE 150
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ENGLEWOOD
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80112-7154
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-770-5065
Provider Business Mailing Address Fax Number:
972-588-1001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8811 AMERICAN WAY
Provider Second Line Business Practice Location Address:
SUITE 150
Provider Business Practice Location Address City Name:
ENGLEWOOD
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80112-7151
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-770-5065
Provider Business Practice Location Address Fax Number:
303-770-8652
Provider Enumeration Date:
01/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MOLLICA
Authorized Official First Name:
ANTHONY
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
972-588-1000

Provider Taxonomy Codes

  • Taxonomy code: 251F00000X , with the licence number:  037000030 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BP3500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336H0001X , with the licence number: 370000030 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336S0011X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 03002664 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 26833 . This is a "DEPARTMENT OF REGULATORY AGENCIES" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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