Healthcare Provider Details

I. General information

NPI: 1003147927
Provider Name (Legal Business Name): 2045 FRANKLIN ST.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2010
Last Update Date: 01/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 FRANKLIN ST
DENVER CO
80205-5437
US

IV. Provider business mailing address

11577 DEPEW WAY
WESTMINSTER CO
80020-6857
US

V. Phone/Fax

Practice location:
  • Phone: 303-614-1492
  • Fax:
Mailing address:
  • Phone: 720-394-9524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MS. PAULA NAYDINE MADRID
Title or Position: MA
Credential:
Phone: 303-614-1492