Provider Demographics
NPI:1235185547
Name:COLORADO HEALTH AND WELLNESS, INC.
Entity Type:Organization
Organization Name:COLORADO HEALTH AND WELLNESS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:719-576-2225
Mailing Address - Street 1:1231 LAKE PLAZA DRIVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-3571
Mailing Address - Country:US
Mailing Address - Phone:719-576-2225
Mailing Address - Fax:719-576-2235
Practice Address - Street 1:1231 LAKE PLAZA DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3571
Practice Address - Country:US
Practice Address - Phone:719-576-2225
Practice Address - Fax:719-576-2235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO111N00000X, 208D00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO6868120001Medicare NSC
COC801228Medicare ID - Type Unspecified