Provider Demographics
NPI:1376785089
Name:SPECIAL DISTRICT, HEART OF THE ROCKIES PHYSICIAN BILLING
Entity Type:Organization
Organization Name:SPECIAL DISTRICT, HEART OF THE ROCKIES PHYSICIAN BILLING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PROVIDER RELATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DESAIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-495-0333
Mailing Address - Street 1:1000 RUSH DR
Mailing Address - Street 2:
Mailing Address - City:SALIDA
Mailing Address - State:CO
Mailing Address - Zip Code:81201
Mailing Address - Country:US
Mailing Address - Phone:719-207-8754
Mailing Address - Fax:
Practice Address - Street 1:1175 58TH AVE
Practice Address - Street 2:STE 202
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-4807
Practice Address - Country:US
Practice Address - Phone:970-495-0300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-26
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty