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NPI Code Detail

MEDICARE: TALLYN'S REACH MEDICAL CENTER LLC

MEDICARE: TALLYN'S REACH MEDICAL CENTER LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QE0002XEmergency Care Clinic/Center18T704CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1434148OTHERCOJCAHO

General Provider Information

NPI Number : 1225437627
Entity Type Code : Organization
Provider Name (Legal Business Name) : TALLYN'S REACH MEDICAL CENTER LLC
Provider Business Mailing Address
First Line : PO BOX 840795
Second Line :
City : DALLAS
State : TX
Zip : 75284-0795
Country : US
Telephone Number : 972-899-6650
Fax Number : 972-899-5954
Provider Business Practice Location Address
First Line : 25551 E SMOKY HILL RD
Second Line :
City : AURORA
State : CO
Zip : 80016-1391
Country : US
Telephone Number : 972-899-6650
Fax Number : 972-899-5954
Authorized Official
Title or Position : CFO
Name : TIM FIELDING
Credential :
Telephone Number : 972-899-6650
Provider Enumeration Date : 08/21/2014
Last Update Date : 11/17/2015

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Directions to “TALLYN'S REACH MEDICAL CENTER LLC ” Practice Location

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