Healthcare Provider Details

I. General information

NPI: 1922147784
Provider Name (Legal Business Name): W III, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 07/26/2021
Certification Date: 07/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1655 EATON ST
LAKEWOOD CO
80214-1628
US

IV. Provider business mailing address

1655 EATON ST
LAKEWOOD CO
80214-1628
US

V. Phone/Fax

Practice location:
  • Phone: 303-238-5363
  • Fax: 303-238-7062
Mailing address:
  • Phone: 303-238-5363
  • Fax: 303-238-7062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0942
License Number StateCO

VIII. Authorized Official

Name: MR. MARK BEDINGER
Title or Position: PRESIDENT/CEO
Credential:
Phone: 303-421-3600