Provider Demographics
NPI:1902154776
Name:COMPREHENSIVE WOMEN'S CARE OF COLORADO SPRINGS, LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE WOMEN'S CARE OF COLORADO SPRINGS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:FOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-358-5377
Mailing Address - Street 1:4810 RUSINA RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-8104
Mailing Address - Country:US
Mailing Address - Phone:719-358-5377
Mailing Address - Fax:719-323-2705
Practice Address - Street 1:4810 RUSINA RD
Practice Address - Street 2:SUITE B
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-8104
Practice Address - Country:US
Practice Address - Phone:719-358-5377
Practice Address - Fax:719-323-2705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-27
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207V00000X
CO42372261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COD46976Medicare UPIN