Provider Demographics
NPI:1275978215
Name:COLORADO MEN'S HEALTH CLINIC
Entity Type:Organization
Organization Name:COLORADO MEN'S HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:COREY
Authorized Official - Middle Name:
Authorized Official - Last Name:COUNTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-412-2092
Mailing Address - Street 1:3003 E 3RD AVE
Mailing Address - Street 2:STE 203
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5110
Mailing Address - Country:US
Mailing Address - Phone:303-322-0255
Mailing Address - Fax:303-321-1541
Practice Address - Street 1:3003 E 3RD AVE
Practice Address - Street 2:STE 203
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5110
Practice Address - Country:US
Practice Address - Phone:303-322-0255
Practice Address - Fax:303-321-1541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-03
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center