1740580695 NPI number — RITA D HINTZ PA

Table of content: RITA D HINTZ PA (NPI 1740580695)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740580695 NPI number — RITA D HINTZ PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HINTZ
Provider First Name:
RITA
Provider Middle Name:
D
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SARMA
Provider Other First Name:
RITA
Provider Other Middle Name:
D
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1740580695
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/21/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
125 RAMPART WAY
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80230-6406
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
720-858-7600
Provider Business Mailing Address Fax Number:
720-858-7615

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1667 COLE BLVD
Provider Second Line Business Practice Location Address:
BLDG 19, SUITE 200
Provider Business Practice Location Address City Name:
LAKEWOOD
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80401-3300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-420-3131
Provider Business Practice Location Address Fax Number:
303-420-1984
Provider Enumeration Date:
10/26/2010

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: 363A00000X , with the licence number:  11 , 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: 11 . This is a "PA LICENSE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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