Healthcare Provider Details
I. General information
NPI: 1740068030
Provider Name (Legal Business Name): HAMME HEALTH ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/18/2023
Last Update Date: 09/18/2023
Certification Date: 09/18/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15715 PAIUTE CIR
MONUMENT CO
80132-6092
US
IV. Provider business mailing address
15715 PAIUTE CIR
MONUMENT CO
80132-6092
US
V. Phone/Fax
- Phone: 719-299-0249
- Fax:
- Phone: 719-299-0249
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
HAMME
Title or Position: OWNER
Credential:
Phone: 719-299-0249