Provider Demographics
NPI:1114108313
Name:TRI-COUNTY HEALTH DEPARTMENT FAMILY PLANNING
Entity Type:Organization
Organization Name:TRI-COUNTY HEALTH DEPARTMENT FAMILY PLANNING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:303-220-9200
Mailing Address - Street 1:6162 S. WILLOW DRIVE
Mailing Address - Street 2:100
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-1617
Mailing Address - Country:US
Mailing Address - Phone:303-220-9200
Mailing Address - Fax:
Practice Address - Street 1:6162 S. WILLOW DRIVE
Practice Address - Street 2:100
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-1617
Practice Address - Country:US
Practice Address - Phone:303-220-9200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRI-COUNTY HEALTH DEPARTMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-16
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04350096Medicaid