1891183299 NPI number — ALLERGY PARTNERS OF COLORADO PC

Table of content: (NPI 1891183299)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891183299 NPI number — ALLERGY PARTNERS OF COLORADO PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLERGY PARTNERS OF COLORADO 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:
1891183299
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/23/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 603725
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLOTTE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28260-3725
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-575-2625
Provider Business Mailing Address Fax Number:
828-350-2174

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2121 E HARMONY RD UNIT 290
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT COLLINS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80528-3402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-221-2370
Provider Business Practice Location Address Fax Number:
970-221-9654
Provider Enumeration Date:
01/07/2015

Additional Information

Authorized Official

Authorized Official Last Name:
BROWN
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT, CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
828-277-1300

Provider Taxonomy Codes

  • Taxonomy code: 207K00000X , 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: 10026893033 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 206922900 , issued by the state of ( WY ) . This identifiers is of the category "MEDICAID".
  • Identifier: W27132 . This is a "MEDICARE PTAN" identifier , issued by the state of ( WY ) . This identifiers is of the category "OTHER".
  • Identifier: 391607 . This is a "MEDICARE PTAN" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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