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General NPI Number Information
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NPI Number | 1528787785
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Entity Type | Organization
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Legal Business Name | PARKVIEW ANCILLARY SERVICES
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Dates
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Enumeration Date | 08/23/2022
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 525 W 15TH ST STE 100
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City | PUEBLO
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State | CO
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Zip | 81003-2716
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Country | US
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Telephone | 719-542-1680
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Fax | 719-542-1681
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Provider Business Mailing Address
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Address Line | 2695 ROCKY MOUNTAIN AVE STE 150
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City | LOVELAND
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State | CO
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Zip | 80538-9071
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF CREDENTIALING
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Name | JANA CONROY
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Credential |
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Telephone | 719-542-1680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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