Provider Demographics
NPI:1861692873
Name:PROFESSIONAL FLU CLINICS, INC.
Entity type:Organization
Organization Name:PROFESSIONAL FLU CLINICS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:W
Authorized Official - Last Name:VOLLMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-757-4808
Mailing Address - Street 1:1600 EMERSON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1412
Mailing Address - Country:US
Mailing Address - Phone:303-757-4546
Mailing Address - Fax:303-675-3306
Practice Address - Street 1:1600 EMERSON ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1412
Practice Address - Country:US
Practice Address - Phone:303-757-4546
Practice Address - Fax:303-675-3306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO60283336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy