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NPI Code Detail

MEDICARE: LIFEVIEW CARE CO, PLLC

MEDICARE: LIFEVIEW CARE CO, PLLC
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
1261Q00000XClinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11609853530OTHERPROVIDER NPI

General Provider Information

NPI Number : 1508146515
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFEVIEW CARE CO, PLLC
Provider Business Mailing Address
First Line : 1535 GRANT ST STE 140
Second Line :
City : DENVER
State : CO
Zip : 80203-1843
Country : US
Telephone Number : 952-500-3337
Fax Number : 855-715-1907
Provider Business Practice Location Address
First Line : 3600 AMERICAN BLVD W STE 225
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55431-1079
Country : US
Telephone Number : 952-500-3337
Fax Number : 855-715-1907
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. THOMAS RAY HARMAN
Credential : M.D.
Telephone Number : 952-426-6427
Provider Enumeration Date : 08/22/2011
Last Update Date : 12/13/2011

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