Healthcare Provider Details

I. General information

NPI: 1063729408
Provider Name (Legal Business Name): MILE HI IMMUNIZATIONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2010
Last Update Date: 08/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

283 COLUMBINE ST #150
DENVER CO
80206-4707
US

IV. Provider business mailing address

283 COLUMBINE ST #150
DENVER CO
80206-4707
US

V. Phone/Fax

Practice location:
  • Phone: 303-374-3374
  • Fax:
Mailing address:
  • Phone: 303-374-3374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SUNNY ALLISON HYNDS
Title or Position: OWNER
Credential:
Phone: 303-374-3374