Provider Demographics
NPI:1386210516
Name:DISPATCHHEALTH ADVANCED CARE LLC
Entity Type:Organization
Organization Name:DISPATCHHEALTH ADVANCED CARE LLC
Other - Org Name:DISPATCHHEALTH ADVANCED CARE FORT WORTH
Other - Org Type:Other Name
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:PALMER
Authorized Official - Last Name:KNEELAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-493-7245
Mailing Address - Street 1:3827 N LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-3339
Mailing Address - Country:US
Mailing Address - Phone:303-500-1815
Mailing Address - Fax:
Practice Address - Street 1:7560 GLENVIEW DR STE 100
Practice Address - Street 2:
Practice Address - City:RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-8374
Practice Address - Country:US
Practice Address - Phone:817-435-1970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DISPATCHHEALTH-TEXAS P A
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-28
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty