Healthcare Provider Details

I. General information

NPI: 1902318702
Provider Name (Legal Business Name): REGENTS OF THE UNIVERSITY OF COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2017
Last Update Date: 04/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 W OXFORD AVE UNIT G-1
DENVER CO
80236-3112
US

IV. Provider business mailing address

3525 W OXFORD AVE UNIT G-1
DENVER CO
80236-3112
US

V. Phone/Fax

Practice location:
  • Phone: 303-315-6150
  • Fax: 720-259-4559
Mailing address:
  • Phone: 303-315-6150
  • Fax: 720-259-4559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License NumberPDO.1680000164
License Number StateCO

VIII. Authorized Official

Name: MARY KRUGMAN
Title or Position: INTERIM DEAN
Credential:
Phone: 303-724-1707