Healthcare Provider Details

I. General information

NPI: 1790343911
Provider Name (Legal Business Name): PAHS ONPOINT IMAGING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2019
Last Update Date: 10/20/2022
Certification Date: 10/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9205 S BROADWAY STE 101
HIGHLANDS RANCH CO
80129-5631
US

IV. Provider business mailing address

1805 SHEA CENTER DR STE 301
HIGHLANDS RANCH CO
80129-2277
US

V. Phone/Fax

Practice location:
  • Phone: 720-603-4353
  • Fax: 720-510-9734
Mailing address:
  • Phone: 303-357-2559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: KATIE LENNON
Title or Position: DIRECTOR, PRACTICE INTEGRATION
Credential:
Phone: 303-738-1100