Healthcare Provider Details

I. General information

NPI: 1346524428
Provider Name (Legal Business Name): REGENTS OF UNIVERSITY OF COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2011
Last Update Date: 10/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1999 N FITZSIMONS PKWY 120
AURORA CO
80045-7503
US

IV. Provider business mailing address

1800 GRANT ST SUITE 600
DENVER CO
80203-1185
US

V. Phone/Fax

Practice location:
  • Phone: 303-344-1292
  • Fax:
Mailing address:
  • Phone: 303-724-0882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number207ND0900X
License Number StateCO

VIII. Authorized Official

Name: DR. RICHARD C KRUGMAN
Title or Position: DEAN
Credential: M..D.
Phone: 303-724-0882