Healthcare Provider Details

I. General information

NPI: 1265007199
Provider Name (Legal Business Name): FEDERAL HEALTHCARE AT HARLAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2021
Last Update Date: 08/02/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4120 FEDERAL BLVD
DENVER CO
80211-1638
US

IV. Provider business mailing address

4120 FEDERAL BLVD
DENVER CO
80211-1638
US

V. Phone/Fax

Practice location:
  • Phone: 303-437-5371
  • Fax: 888-879-1516
Mailing address:
  • Phone: 303-437-5371
  • Fax: 888-879-1516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT COVINGTON SPRINGS
Title or Position: OWNER/PROVIDER
Credential:
Phone: 303-437-5371