Healthcare Provider Details

I. General information

NPI: 1962987651
Provider Name (Legal Business Name): BMH CORP INC HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2018
Last Update Date: 02/14/2023
Certification Date: 02/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7950 E MISSISSIPPI AVE STE C
AURORA CO
80247-2151
US

IV. Provider business mailing address

7950 E MISSISSIPPI AVE STE C
DENVER CO
80247-2151
US

V. Phone/Fax

Practice location:
  • Phone: 303-353-1440
  • Fax: 303-353-4206
Mailing address:
  • Phone: 720-436-7613
  • Fax: 303-353-4206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LEONID REZNIKOV
Title or Position: CEO
Credential: MD
Phone: 303-353-1440