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NPI Code Detail

MEDICARE: BUCKEYE A, LLC

MEDICARE: BUCKEYE A, 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
1314000000XSkilled Nursing Facility0318CO

Other Identifiers

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

General Provider Information

NPI Number : 1962493809
Entity Type Code : Organization
Provider Name (Legal Business Name) : BUCKEYE A, LLC
Provider Business Mailing Address
First Line : 12136 W. BAYAUD AVENUE
Second Line : SUITE 200
City : LAKEWOOD
State : CO
Zip : 80228-2115
Country : US
Telephone Number : 303-238-3838
Fax Number : 303-987-0434
Provider Business Practice Location Address
First Line : 3131 S. FEDERAL BLVD
Second Line :
City : DENVER
State : CO
Zip : 80236-2713
Country : US
Telephone Number : 303-761-0260
Fax Number : 303-761-7088
Authorized Official
Title or Position : PRESIDENT
Name : JAY MOSKOWITZ
Credential : CPA
Telephone Number : 303-238-3838
Provider Enumeration Date : 10/31/2005
Last Update Date : 05/25/2016

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Directions to “BUCKEYE A, LLC ” Practice Location

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