Provider Demographics
NPI:1114491065
Name:AWP MEDICAL HOLDINGS LLC
Entity Type:Organization
Organization Name:AWP MEDICAL HOLDINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:VANNEHE
Authorized Official - Middle Name:
Authorized Official - Last Name:EICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-369-1077
Mailing Address - Street 1:1550 S POTOMAC ST STE 230
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-5455
Mailing Address - Country:US
Mailing Address - Phone:303-369-1077
Mailing Address - Fax:303-369-9785
Practice Address - Street 1:1550 S POTOMAC ST STE 230
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-5455
Practice Address - Country:US
Practice Address - Phone:303-369-1077
Practice Address - Fax:303-369-9785
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AWP MEDICAL HOLDINGS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care