Healthcare Provider Details

I. General information

NPI: 1295547594
Provider Name (Legal Business Name): CS CARDIOLOGY NEWCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2025
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2312 N NEVADA AVE STE 235
COLORADO SPRINGS CO
80907-5312
US

IV. Provider business mailing address

PO BOX 88143
CHICAGO IL
60680-1143
US

V. Phone/Fax

Practice location:
  • Phone: 719-776-7600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MEGAN THOMAS
Title or Position: RCM CONTRACTS MANAGER
Credential:
Phone: 224-285-6266