MEDICARE: BMH CORP INC HEALTH CENTER

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207Q00000X	Family Medicine Physician
2	261QP2000X	Physical Therapy Clinic/Center
3	363LP2300X	Primary Care Nurse Practitioner
4	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1962987651
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BMH CORP INC HEALTH CENTER

Provider Business Mailing Address
First Line	:	7950 E MISSISSIPPI AVE STE C
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80247-2151
Country	:	US
Telephone Number	:	720-436-7613
Fax Number	:	303-353-4206

Provider Business Practice Location Address
First Line	:	7950 E MISSISSIPPI AVE STE C
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80247-2151
Country	:	US
Telephone Number	:	303-353-1440
Fax Number	:	303-353-4206

Authorized Official
Title or Position	:	CEO
Name	:	LEONID REZNIKOV
Credential	:	MD
Telephone Number	:	303-353-1440

Provider Enumeration Date	:	09/27/2018
Last Update Date	:	02/14/2023

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