Provider Demographics
NPI:1902128507
Name:URGENT CARE CENTENNIAL PC
Entity Type:Organization
Organization Name:URGENT CARE CENTENNIAL PC
Other - Org Name:DOCTORS EXPRESS URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:NITCHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-220-9172
Mailing Address - Street 1:8006 E ARAPAHOE RD
Mailing Address - Street 2:UNIT 100
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-6815
Mailing Address - Country:US
Mailing Address - Phone:303-220-9168
Mailing Address - Fax:
Practice Address - Street 1:8006 E ARAPAHOE RD
Practice Address - Street 2:UNIT 100
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-6815
Practice Address - Country:US
Practice Address - Phone:303-220-9168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-23
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO68674571Medicaid
CO6673440001Medicare NSC
COCOA101358Medicare PIN