Provider Demographics
NPI:1386854354
Name:MEDNOW CLINICS, INC.
Entity Type:Organization
Organization Name:MEDNOW CLINICS, INC.
Other - Org Name:MEDNOW CLINICS-LAKEWOOD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-878-7055
Mailing Address - Street 1:2224 S FRASER ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-4548
Mailing Address - Country:US
Mailing Address - Phone:720-878-7055
Mailing Address - Fax:720-390-5188
Practice Address - Street 1:1555 S WADSWORTH BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-6832
Practice Address - Country:US
Practice Address - Phone:303-985-1597
Practice Address - Fax:303-985-2108
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDNOW CLINICS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-22
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO96287837Medicaid
COC350408Medicare PIN