=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790340131
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HCA-HEALTHONE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/01/2019
-----------------------------------------------------
Last Update Date | 10/24/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6196 S AMMONS WAY
-----------------------------------------------------
City | LITTLETON
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80123-4109
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-932-6911
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6196 S AMMONS WAY
-----------------------------------------------------
City | LITTLETON
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80123-4109
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-932-6911
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | JAMIE LEIGH GIBBS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 303-788-5000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QE0002X
-----------------------------------------------------
Taxonomy Name | Emergency Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------