Provider Demographics
NPI:1093313900
Name:GI CARE OF COLORADO PLLC
Entity Type:Organization
Organization Name:GI CARE OF COLORADO PLLC
Other - Org Name:SOUTH DENVER GI CASTLE ROCK, DIVISION OF GI CARE OF COLORADO PLLC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-788-8888
Mailing Address - Street 1:10 INVERNESS DR E STE 220
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-5612
Mailing Address - Country:US
Mailing Address - Phone:303-788-8888
Mailing Address - Fax:303-768-8774
Practice Address - Street 1:3911 AMBROSIA ST STE 201
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80109-3888
Practice Address - Country:US
Practice Address - Phone:303-788-8888
Practice Address - Fax:303-788-6452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-13
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty