1801908900 NPI number — WELLINGTON MEDICAL CENTER LLC

Table of content: (NPI 1801908900)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801908900 NPI number — WELLINGTON MEDICAL CENTER LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WELLINGTON MEDICAL CENTER 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:
WELLINGTON MEDICAL CENTER
Provider Other Organization Name Type Code:
3
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:
1801908900
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/15/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
214 E 23RD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHEYENNE
Provider Business Mailing Address State Name:
WY
Provider Business Mailing Address Postal Code:
82001-3748
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
307-633-3096
Provider Business Mailing Address Fax Number:
307-633-3019

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7859 6TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WELLINGTON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80549-1500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-568-4800
Provider Business Practice Location Address Fax Number:
970-568-4165
Provider Enumeration Date:
08/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HARMS
Authorized Official First Name:
CHARLES
Authorized Official Middle Name:
F
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
307-633-7600

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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