1609270404 NPI number — JOSHUA LOREN MCGIRK BCTMB, YA 500, C-IAY

Table of content: JOSHUA LOREN MCGIRK BCTMB, YA 500, C-IAY (NPI 1609270404)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609270404 NPI number — JOSHUA LOREN MCGIRK BCTMB, YA 500, C-IAY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCGIRK
Provider First Name:
JOSHUA
Provider Middle Name:
LOREN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
BCTMB, YA 500, C-IAY
Provider Gender Code:
M

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:
1609270404
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/24/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3443 S GALENA ST STE 150
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80231-5524
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
720-935-9980
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3443 S GALENA ST STE 150
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:
80231-5524
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-935-9980
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/22/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225700000X , with the licence number:  0005487 , 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: 1609240404 . This is a "NPI" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".