Provider Demographics
NPI:1083273049
Name:MEDICAL CENTER CORP
Entity Type:Organization
Organization Name:MEDICAL CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:VATAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-946-3322
Mailing Address - Street 1:1780 S BELLAIRE ST STE 402
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-4323
Mailing Address - Country:US
Mailing Address - Phone:303-946-3322
Mailing Address - Fax:
Practice Address - Street 1:5800 E EVANS AVE STE 101
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-5320
Practice Address - Country:US
Practice Address - Phone:303-946-3322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-12
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care