Healthcare Provider Details

I. General information

NPI: 1952910721
Provider Name (Legal Business Name): SCL PHYSICIANS - RMPC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2020
Last Update Date: 07/28/2020
Certification Date: 07/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5730 WARD RD STE 102
ARVADA CO
80002-1300
US

IV. Provider business mailing address

500 ELDORADO BLVD STE 6300
BROOMFIELD CO
80021-3422
US

V. Phone/Fax

Practice location:
  • Phone: 303-422-6331
  • Fax: 303-422-6379
Mailing address:
  • Phone: 303-272-0566
  • Fax: 303-272-0390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: JON MCDANIEL
Title or Position: VP FINANCE PSO
Credential:
Phone: 303-272-0231