Provider Demographics
NPI:1407054596
Name:BEAUDOIN & PAPAGNO CONSTRUCTION CORPORATION
Entity Type:Organization
Organization Name:BEAUDOIN & PAPAGNO CONSTRUCTION CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:BEAUDOIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-488-7932
Mailing Address - Street 1:6428 S QUEBEC ST
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4628
Mailing Address - Country:US
Mailing Address - Phone:720-488-7932
Mailing Address - Fax:720-488-7931
Practice Address - Street 1:6428 S QUEBEC ST
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111-4628
Practice Address - Country:US
Practice Address - Phone:720-488-7932
Practice Address - Fax:720-488-7931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO37301390Medicaid