Healthcare Provider Details

I. General information

NPI: 1205483716
Provider Name (Legal Business Name): PAM SPECIALTY HOSPITAL OF DENVER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2019
Last Update Date: 08/03/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1690 N MEADE ST
DENVER CO
80204
US

IV. Provider business mailing address

1828 GOOD HOPE RD
ENOLA PA
17025-1203
US

V. Phone/Fax

Practice location:
  • Phone: 303-264-6900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY MISITANO
Title or Position: PRESIDENT
Credential:
Phone: 717-731-9660