Healthcare Provider Details

I. General information

NPI: 1962643288
Provider Name (Legal Business Name): 1ST ALLERGY ASTHMA AND PEDIATRICS TOO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2009
Last Update Date: 12/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3260 E 104TH AVE
THORNTON CO
80233-4406
US

IV. Provider business mailing address

8601 S. YOSEMITE ST
CENTENNIAL CO
80112-1406
US

V. Phone/Fax

Practice location:
  • Phone: 720-929-8300
  • Fax: 720-929-8444
Mailing address:
  • Phone: 303-773-9000
  • Fax: 720-488-4149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number32130
License Number StateCO

VIII. Authorized Official

Name: MRS. ERIN COLLEEN HELMS
Title or Position: BILLING MANAGER
Credential:
Phone: 303-224-4717