Provider Demographics
NPI:1033254925
Name:DENVER HEALTH AND HOSPITAL AUTHORITY
Entity Type:Organization
Organization Name:DENVER HEALTH AND HOSPITAL AUTHORITY
Other - Org Name:DENVER HEALTH CENTRAL FILL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANSAR
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:303-602-7083
Mailing Address - Street 1:500 QUIVAS ST
Mailing Address - Street 2:STE A
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4916
Mailing Address - Country:US
Mailing Address - Phone:303-602-2020
Mailing Address - Fax:303-602-2344
Practice Address - Street 1:500 QUIVAS ST
Practice Address - Street 2:STE A
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4916
Practice Address - Country:US
Practice Address - Phone:303-602-2020
Practice Address - Fax:303-602-2344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CO5603336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO28970845Medicaid
2003700OtherPK