Healthcare Provider Details
I. General information
NPI: 1669420410
Provider Name (Legal Business Name): TOTAL HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/04/2006
Last Update Date: 09/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2222 N NEVADA AVE STE 201
COLORADO SPRINGS CO
80907-6831
US
IV. Provider business mailing address
DEPARTMENT 1322
DENVER CO
80291-1322
US
V. Phone/Fax
- Phone: 719-776-5454
- Fax: 719-776-2516
- Phone: 303-486-5500
- Fax: 303-486-5501
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RAMY
HANNA
Title or Position: CFO
Credential:
Phone: 303-804-8189