Provider Demographics
NPI:1376536540
Name:1ST ALLERGY ASTHMA AND PEDIATRICS TOO, INC.
Entity Type:Organization
Organization Name:1ST ALLERGY ASTHMA AND PEDIATRICS TOO, INC.
Other - Org Name:HORIZON PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:MELAMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-773-9000
Mailing Address - Street 1:9191 HURON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80260-6842
Mailing Address - Country:US
Mailing Address - Phone:303-225-0080
Mailing Address - Fax:303-487-9103
Practice Address - Street 1:9191 HURON ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80260-6842
Practice Address - Country:US
Practice Address - Phone:303-225-0080
Practice Address - Fax:303-487-9103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO30788331Medicaid
CO30788331Medicaid