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General NPI Number Information
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NPI Number | 1780090910
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Entity Type | Organization
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Legal Business Name | PIKES PEAK NEURO CARE, LLC
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Dates
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Enumeration Date | 07/09/2014
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 110 16TH ST STE 1460
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City | DENVER
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State | CO
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Zip | 80202-5202
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Country | US
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Telephone | 734-245-9892
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 713595 CNM-VELOCITY
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City | CHICAGO
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State | IL
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Zip | 60677-4410
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Country | US
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Telephone | 734-245-9892
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Fax |
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Authorized Official
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Title or Position | ENTITY OWNER
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Name | ANDREW BENJAMIN HARRIS
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Credential |
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Telephone | 197-338-6715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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