Healthcare Provider Details
I. General information
NPI: 1083352876
Provider Name (Legal Business Name): SWEDISH PORTER EKG INTERPRETATION SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/23/2022
Last Update Date: 05/23/2022
Certification Date: 05/23/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7700 S. BROADWAY
LITTLETON CO
80122-2602
US
IV. Provider business mailing address
3464 S. WILLOW STREET STE 102
DENVER CO
80231-4531
US
V. Phone/Fax
- Phone: 303-730-8900
- Fax:
- Phone: 303-755-2900
- Fax: 303-755-0404
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GEORGE
FRANK
Title or Position: MANAGING PARTNER
Credential:
Phone: 303-933-8240