1700585676 NPI number — 333 CORP

Table of content: (NPI 1700585676)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700585676 NPI number — 333 CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
333 CORP
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:
1700585676
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/28/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9457 S UNIVERSITY BLVD STE 200-636
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:
80126-4976
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
720-891-8127
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10579 JEWELBERRY TRL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HIGHLANDS RANCH
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80130-8929
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-891-1807
Provider Business Practice Location Address Fax Number:
866-374-0253
Provider Enumeration Date:
02/28/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
READ
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
720-891-8127

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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