1700104379 NPI number — CME4HEALTH WOMENS CARE LLC

Table of content: (NPI 1700104379)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700104379 NPI number — CME4HEALTH WOMENS CARE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CME4HEALTH WOMENS CARE 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:
1700104379
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/16/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2463 S OAKLAND CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AURORA
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80014-1887
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-695-7873
Provider Business Mailing Address Fax Number:
303-745-6925

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3600 E ALAMEDA AVE
Provider Second Line Business Practice Location Address:
SUITE 120
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80209-3189
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-695-7873
Provider Business Practice Location Address Fax Number:
303-745-6925
Provider Enumeration Date:
05/06/2010

Additional Information

Authorized Official

Authorized Official Last Name:
HENDRIX
Authorized Official First Name:
MARY
Authorized Official Middle Name:
LOU
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
303-695-7873

Provider Taxonomy Codes

  • Taxonomy code: 363LW0102X , with the licence number:  47375 , 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)





Copyright © 2007-2025 www.npivalidator.com