Provider Demographics
NPI:1346859014
Name:SCL PHYSICIANS - RMPC LLC
Entity Type:Organization
Organization Name:SCL PHYSICIANS - RMPC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP FIANCE PSO
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-272-0231
Mailing Address - Street 1:500 ELDORADO BLVD STE 6300
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-3422
Mailing Address - Country:US
Mailing Address - Phone:303-272-0566
Mailing Address - Fax:303-272-0390
Practice Address - Street 1:8585 W 14TH AVE STE B-2
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-4860
Practice Address - Country:US
Practice Address - Phone:303-238-1201
Practice Address - Fax:303-238-2981
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCL HEALTH MEDICAL GROUP - DENVER, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty