MEDICARE: RMCHS MANAGEMENT SERVICES

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	2085P0229X	Pediatric Radiology Physician
2	2085R0202X	Diagnostic Radiology Physician

General Provider Information

NPI Number	:	1770765992
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RMCHS MANAGEMENT SERVICES

Provider Business Mailing Address
First Line	:	THE CHILDREN'S HOSPITAL RADIOLOGY PROFESSIONALS
Second Line	:	DEPT. 2065
City	:	DENVER
State	:	CO
Zip	:	80291-2056
Country	:	US
Telephone Number	:	303-861-6164
Fax Number	:	303-764-8049

Provider Business Practice Location Address
First Line	:	THE CHILDREN'S HOSPITAL RADIOLOGY PROFESSIONALS
Second Line	:	DEPT. 2065
City	:	DENVER
State	:	CO
Zip	:	80291-2056
Country	:	US
Telephone Number	:	303-861-6164
Fax Number	:	303-764-8049

Authorized Official
Title or Position	:	CFO
Name	:	MR. JEFF HARRINGTON
Credential	:
Telephone Number	:	303-861-6164

Provider Enumeration Date	:	11/29/2007
Last Update Date	:	11/29/2007

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