Healthcare Provider Details

I. General information

NPI: 1689632176
Provider Name (Legal Business Name): SWEDISH PORTER EKG INTERPRETATION SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 11/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E HAMPDEN AVE
ENGLEWOOD CO
80113-2702
US

IV. Provider business mailing address

3464 S WILLOW ST
DENVER CO
80231-4531
US

V. Phone/Fax

Practice location:
  • Phone: 303-744-2706
  • Fax:
Mailing address:
  • Phone: 303-755-2900
  • Fax: 303-755-0404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD B CAPEK
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 303-744-2706