Healthcare Provider Details

I. General information

NPI: 1871965459
Provider Name (Legal Business Name): THOMAS E. CAMPBELL CONSTRUCTION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2015
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 S CLINTON ST 8A
DENVER CO
80247-1586
US

IV. Provider business mailing address

605 S CLINTON ST 8A
DENVER CO
80247-1586
US

V. Phone/Fax

Practice location:
  • Phone: 720-377-6018
  • Fax:
Mailing address:
  • Phone: 720-377-6018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number2013-790671 01 SL
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: THOMAS EUGENE CAMPBELL
Title or Position: CEO
Credential:
Phone: 720-377-6018