Provider Demographics
NPI:1164897682
Name:DENVER ARTHRITIS CLINIC
Entity Type:Organization
Organization Name:DENVER ARTHRITIS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:RENDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-302-7350
Mailing Address - Street 1:200 SPRUCE ST
Mailing Address - Street 2:100
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-7126
Mailing Address - Country:US
Mailing Address - Phone:303-394-2828
Mailing Address - Fax:303-320-0242
Practice Address - Street 1:200 SPRUCE ST
Practice Address - Street 2:100
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7126
Practice Address - Country:US
Practice Address - Phone:303-394-2828
Practice Address - Fax:303-320-0242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO55538207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1194915579OtherNPI