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NPI Code Detail

MEDICARE: BUCKEYE A, LLC

MEDICARE: BUCKEYE A, LLC
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
1314000000XSkilled Nursing Facility020405CO

General Provider Information

NPI Number : 1689111783
Entity Type Code : Organization
Provider Name (Legal Business Name) : BUCKEYE A, LLC
Provider Business Mailing Address
First Line : 3131 S FEDERAL BLVD
Second Line :
City : DENVER
State : CO
Zip : 80236-2713
Country : US
Telephone Number : 303-761-0260
Fax Number : 303-796-7088
Provider Business Practice Location Address
First Line : 3131 S FEDERAL BLVD
Second Line :
City : DENVER
State : CO
Zip : 80236-2713
Country : US
Telephone Number : 303-761-0260
Fax Number : 303-796-7088
Authorized Official
Title or Position : DIRECTOR OF REIMBURSEMENT
Name : MARY KORETKE
Credential :
Telephone Number : 720-974-6278
Provider Enumeration Date : 01/26/2017
Last Update Date : 01/26/2017

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Directions to “BUCKEYE A, LLC ” Practice Location

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