Provider Demographics
NPI:1861777260
Name:HERITAGE HILLS FAMILY MEDICINE, PC
Entity type:Organization
Organization Name:HERITAGE HILLS FAMILY MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREAS
Authorized Official - Middle Name:
Authorized Official - Last Name:EDRICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-792-3333
Mailing Address - Street 1:2980 N BEVERLY GLEN CIR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1726
Mailing Address - Country:US
Mailing Address - Phone:310-943-4180
Mailing Address - Fax:
Practice Address - Street 1:7000 E BELLEVIEW AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-1617
Practice Address - Country:US
Practice Address - Phone:303-792-3333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HERITAGE HILLS FAMILY MEDICINE, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-10-17
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site