Provider Demographics
NPI:1407008386
Name:UNIVERSITY OF COLORADO DENVER
Entity Type:Organization
Organization Name:UNIVERSITY OF COLORADO DENVER
Other - Org Name:HEALTH SCIENCES CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:PROFESSOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:THOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-724-3704
Mailing Address - Street 1:12801 E 17TH AVE
Mailing Address - Street 2:RM L18-5104
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2530
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12801 E 17TH AVE
Practice Address - Street 2:RM L18-5104
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2530
Practice Address - Country:US
Practice Address - Phone:303-724-3080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO29250291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory