MEDICARE: DENVER NMR, INC

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	261QM1200X	Magnetic Resonance Imaging (MRI) Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699747857
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENVER NMR, INC

Provider Business Mailing Address
First Line	:	PO BOX 140097
Second Line	:
City	:	EDGEWATER
State	:	CO
Zip	:	80214-0097
Country	:	US
Telephone Number	:	303-623-5701
Fax Number	:	720-932-9109

Provider Business Practice Location Address
First Line	:	4231 W 16TH AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-1335
Country	:	US
Telephone Number	:	303-623-5701
Fax Number	:	720-932-9109

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RANDALL H LORTSCHER
Credential	:	M.D.
Telephone Number	:	303-623-5701

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	03/17/2008

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