Provider Demographics
NPI:1275537706
Name:SOUTH DENVER PULMONARY ASSOCIATES PC
Entity Type:Organization
Organization Name:SOUTH DENVER PULMONARY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGRATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-788-8500
Mailing Address - Street 1:499 E HAMPDEN AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2793
Mailing Address - Country:US
Mailing Address - Phone:303-788-8500
Mailing Address - Fax:303-788-8505
Practice Address - Street 1:499 E HAMPDEN AVE
Practice Address - Street 2:STE 300
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2793
Practice Address - Country:US
Practice Address - Phone:303-788-8500
Practice Address - Fax:303-788-8505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-13
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COGROUP207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04878047Medicaid
COC87804Medicare PIN