MEDICARE: REGENTS OF THE UNIVERSITY OF COLORADO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0400X	Federally Qualified Health Center (FQHC)		CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194921411
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGENTS OF THE UNIVERSITY OF COLORADO

Provider Business Mailing Address
First Line	:	4107-B S. FEDERAL BOULEVARD
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80110-4316
Country	:	US
Telephone Number	:	303-315-6150
Fax Number	:	303-783-9978

Provider Business Practice Location Address
First Line	:	4107B S. FEDERAL BOULEVARD
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80110-4316
Country	:	US
Telephone Number	:	303-315-6150
Fax Number	:	303-783-9978

Authorized Official
Title or Position	:	DEAN COLLEGE OF NURSING
Name	:	SARAH THOMPSON
Credential	:	PHD, RN
Telephone Number	:	303-724-1679

Provider Enumeration Date	:	06/24/2007
Last Update Date	:	08/23/2016

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