Provider Demographics
NPI:1003257650
Name:WESTERN HEALTH AND SAFETY
Entity Type:Organization
Organization Name:WESTERN HEALTH AND SAFETY
Other - Org Name:UNITED DIAGNOSTIC SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRINCIPLE
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:BRADLEY
Authorized Official - Last Name:SISSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-221-9451
Mailing Address - Street 1:PO BOX 889
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80539-0889
Mailing Address - Country:US
Mailing Address - Phone:970-776-3190
Mailing Address - Fax:970-416-9676
Practice Address - Street 1:7251 W 20TH ST
Practice Address - Street 2:BULDING N #2
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634
Practice Address - Country:US
Practice Address - Phone:970-776-3190
Practice Address - Fax:970-416-9676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-11
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO06D2058723291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory