Healthcare Provider Details

I. General information

NPI: 1114447471
Provider Name (Legal Business Name): WESTEX CONSTRUCTION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2017
Last Update Date: 06/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 GENOA ST
DENVER CO
80249-6629
US

IV. Provider business mailing address

PO BOX 17291
DENVER CO
80217-0291
US

V. Phone/Fax

Practice location:
  • Phone: 720-404-5324
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: MISS TIFFANY WASHINGTON
Title or Position: PRESIDENT
Credential:
Phone: 720-404-5324