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General NPI Number Information
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NPI Number | 1861281628
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Entity Type | Organization
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Legal Business Name | CS CARDIOLOGY NEWCO LLC
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Dates
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Enumeration Date | 05/06/2025
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 1 MERCADO ST STE 130
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City | DURANGO
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State | CO
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Zip | 81301-7306
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Country | US
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Telephone | 970-764-2600
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Fax | 970-247-1128
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Provider Business Mailing Address
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Address Line | PO BOX 88143
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City | CHICAGO
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State | IL
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Zip | 60680-1143
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Country | US
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Telephone | 719-445-7544
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF PAYER CONTRACTING
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Name | MEGAN THOMAS
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Credential |
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Telephone | 224-285-6266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease 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 | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number |
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License Number State |
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