Provider Demographics
NPI:1538829627
Name:CHILDREN'S HOSPITAL COLORADO
Entity type:Organization
Organization Name:CHILDREN'S HOSPITAL COLORADO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-777-6537
Mailing Address - Street 1:13123 E 16TH AVE # B450
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-7106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:609 E MADISON AVE
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:WY
Practice Address - Zip Code:82501-4756
Practice Address - Country:US
Practice Address - Phone:307-330-8183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHILDREN'S HOSPITAL COLORADO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-12-30
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty