Healthcare Provider Details

I. General information

NPI: 1144755307
Provider Name (Legal Business Name): AUXILLIUM MEDICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2017
Last Update Date: 04/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 S SHERIDAN BLVD
LAKEWOOD CO
80226-2451
US

IV. Provider business mailing address

275 S SHERIDAN BLVD
LAKEWOOD CO
80226-2451
US

V. Phone/Fax

Practice location:
  • Phone: 720-595-6519
  • Fax: 303-980-0861
Mailing address:
  • Phone: 720-595-6519
  • Fax: 303-980-0861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: THUY K NGUYEN
Title or Position: PRESIDENT
Credential:
Phone: 720-595-6519