1720646250 NPI number — ALLPRIA HEALTHCARE

Table of content: (NPI 1720646250)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720646250 NPI number — ALLPRIA HEALTHCARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLPRIA HEALTHCARE
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:
1720646250
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/30/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 370832
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:
80237-0832
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
833-834-7246
Provider Business Mailing Address Fax Number:
720-502-5271

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10700 E BETHANY DR STE 104
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AURORA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80014-2625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
833-834-7246
Provider Business Practice Location Address Fax Number:
720-502-5271
Provider Enumeration Date:
05/30/2019

Additional Information

Authorized Official

Authorized Official Last Name:
HENRY
Authorized Official First Name:
ANNA
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
833-834-7246

Provider Taxonomy Codes

  • Taxonomy code: 208VP0014X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 9000162178 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com