Provider Demographics
NPI:1073219242
Name:VMD PRIMARY PROVIDERS COLORADO, INC
Entity Type:Organization
Organization Name:VMD PRIMARY PROVIDERS COLORADO, INC
Other - Org Name:VILLAGE MEDICAL - SOUTH COLLEGE
Other - Org Type:Other Name
Authorized Official - Title/Position:SENIOR DIRECTOR REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:I
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-969-0686
Mailing Address - Street 1:PO BOX 360301
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-6301
Mailing Address - Country:US
Mailing Address - Phone:844-969-0686
Mailing Address - Fax:773-832-7083
Practice Address - Street 1:2614 S COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-2138
Practice Address - Country:US
Practice Address - Phone:970-224-1670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VMD PRIMARY PROVIDERS COLORADO, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-31
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty