Provider Demographics
NPI:1003831835
Name:HOSPICE OF METRO DENVER, INC
Entity Type:Organization
Organization Name:HOSPICE OF METRO DENVER, INC
Other - Org Name:THE DENVER HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-780-4600
Mailing Address - Street 1:8289 E LOWRY BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-7256
Mailing Address - Country:US
Mailing Address - Phone:303-321-2828
Mailing Address - Fax:303-336-1245
Practice Address - Street 1:8289 E LOWRY BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7256
Practice Address - Country:US
Practice Address - Phone:303-321-2828
Practice Address - Fax:303-336-1245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0968251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05800057Medicaid
CO061504Medicare ID - Type UnspecifiedHOSPICE OF METRO DENVER