Healthcare Provider Details

I. General information

NPI: 1730865080
Provider Name (Legal Business Name): HEPQUANT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2023
Last Update Date: 12/20/2023
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12635 E MONTVIEW BLVD STE 175L1
AURORA CO
80045-7335
US

IV. Provider business mailing address

8100 E UNION AVE UNIT 750
DENVER CO
80237-2974
US

V. Phone/Fax

Practice location:
  • Phone: 303-923-2242
  • Fax: 303-751-4777
Mailing address:
  • Phone: 303-923-2242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: GREGORY EVERSON
Title or Position: CEO
Credential: MD
Phone: 303-923-2242