1801493515 NPI number — ALLERGY, ASTHMA & IMMUNOLOGY OF THE ROCKIES, PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801493515 NPI number — ALLERGY, ASTHMA & IMMUNOLOGY OF THE ROCKIES, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLERGY, ASTHMA & IMMUNOLOGY OF THE ROCKIES, PC
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:
1801493515
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/12/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX #2601
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLENWOOD SPRINGS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81602-2601
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-947-0600
Provider Business Mailing Address Fax Number:
970-947-0601

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
0401 CASTLE CREEK ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASPEN
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81611
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-947-0600
Provider Business Practice Location Address Fax Number:
970-947-0601
Provider Enumeration Date:
10/06/2020

Additional Information

Authorized Official

Authorized Official Last Name:
FLYNN
Authorized Official First Name:
LILY
Authorized Official Middle Name:
Authorized Official Title or Position:
REVENUE INTEGRITY ADMINISTRATOR
Authorized Official Telephone Number:
469-209-8355

Provider Taxonomy Codes

  • Taxonomy code: 207K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 51036746 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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