MEDICARE: LEXILIFE HEALTH CLINICS, 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
1	174400000X	Specialist		CO

General Provider Information

NPI Number	:	1275753113
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEXILIFE HEALTH CLINICS, LLC.

Provider Business Mailing Address
First Line	:	6777 E HAMPDEN AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80224-3005
Country	:	US
Telephone Number	:	303-782-5026
Fax Number	:

Provider Business Practice Location Address
First Line	:	6777 E HAMPDEN AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80224-3005
Country	:	US
Telephone Number	:	303-782-5026
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. DAVID BARRY PALMSTEIN
Credential	:
Telephone Number	:	303-782-5026

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	08/22/2020

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