Provider Demographics
NPI:1114778289
Name:VIVO INFUSION COLORADO, LLC
Entity Type:Organization
Organization Name:VIVO INFUSION COLORADO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:ROTTURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-323-8987
Mailing Address - Street 1:1726 COLE BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3262
Mailing Address - Country:US
Mailing Address - Phone:855-478-1528
Mailing Address - Fax:972-598-0019
Practice Address - Street 1:1402 S PARKER RD # ATEA-104
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-2758
Practice Address - Country:US
Practice Address - Phone:855-478-1528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VIVO INFUSION COLORADO, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy