Healthcare Provider Details
I. General information
NPI: 1831792233
Provider Name (Legal Business Name): GREENWOOD PEDIATRICS PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/18/2020
Last Update Date: 02/11/2022
Certification Date: 02/11/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8331 S CONTINENTAL DIVIDE RD
LITTLETON CO
80127-4231
US
IV. Provider business mailing address
9094 E MINERAL AVE SUITE 100
CENTENNIAL CO
80112-7200
US
V. Phone/Fax
- Phone: 303-973-3200
- Fax: 303-904-8510
- Phone: 303-694-3200
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTINA
BECKER
Title or Position: DIRECTOR OF BILLING
Credential:
Phone: 720-633-8580