Provider Demographics
NPI:1225669518
Name:OPTUMCARE COLORADO SPRINGS, LLC
Entity Type:Organization
Organization Name:OPTUMCARE COLORADO SPRINGS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:M
Authorized Official - Last Name:DECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-538-2900
Mailing Address - Street 1:2 S CASCADE AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-1604
Mailing Address - Country:US
Mailing Address - Phone:719-538-2900
Mailing Address - Fax:719-538-2996
Practice Address - Street 1:6071 E WOODMEN RD STE 105
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-2610
Practice Address - Country:US
Practice Address - Phone:719-597-8704
Practice Address - Fax:719-597-6864
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPTUMCARE COLORADO SPRINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty