Healthcare Provider Details

I. General information

NPI: 1629527494
Provider Name (Legal Business Name): CHER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2016
Last Update Date: 05/18/2023
Certification Date: 05/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 PROFESSIONAL LN SUITE 175
LONGMONT CO
80501-6972
US

IV. Provider business mailing address

8610 EXPLORER DR SUITE 300
COLORADO SPRINGS CO
80920-1058
US

V. Phone/Fax

Practice location:
  • Phone: 719-955-4332
  • Fax: 719-358-5401
Mailing address:
  • Phone: 719-955-4332
  • Fax: 719-358-5401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JEFF JONES
Title or Position: CFO
Credential:
Phone: 719-955-4332