Healthcare Provider Details

I. General information

NPI: 1063714095
Provider Name (Legal Business Name): ARCH 2007 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2010
Last Update Date: 11/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 UNIVERSITY BLVD SUITE 204
DENVER CO
80206-4657
US

IV. Provider business mailing address

1415 BELLAIRE ST
DENVER CO
80220-2412
US

V. Phone/Fax

Practice location:
  • Phone: 303-355-1695
  • Fax: 303-355-1834
Mailing address:
  • Phone: 720-530-1122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: RICHARD CHARLES
Title or Position: CEO
Credential: DPM
Phone: 720-530-1122