Provider Demographics
NPI:1043351539
Name:DENVER METRO IMAGING, LLC
Entity Type:Organization
Organization Name:DENVER METRO IMAGING, LLC
Other - Org Name:PARK MEADOWS IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HANEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-367-2225
Mailing Address - Street 1:8500 PARK MEADOWS DRIVE
Mailing Address - Street 2:SUITE 050
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124
Mailing Address - Country:US
Mailing Address - Phone:303-925-0674
Mailing Address - Fax:303-951-7528
Practice Address - Street 1:8500 PARK MEADOWS DRIVE
Practice Address - Street 2:SUITE 050
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124
Practice Address - Country:US
Practice Address - Phone:303-925-0674
Practice Address - Fax:303-951-7528
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPINE ONE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-09
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE261QR0200X
261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOB5010Medicare UPIN