Provider Demographics
NPI:1417986134
Name:COLORADO ALLERGY AND ASTHMA CENTERS, PC
Entity Type:Organization
Organization Name:COLORADO ALLERGY AND ASTHMA CENTERS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO/CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MILEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-858-7431
Mailing Address - Street 1:125 RAMPART WAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-6406
Mailing Address - Country:US
Mailing Address - Phone:720-858-7434
Mailing Address - Fax:720-858-7605
Practice Address - Street 1:125 RAMPART WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-6406
Practice Address - Country:US
Practice Address - Phone:720-858-7434
Practice Address - Fax:720-858-7605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
CO40389174400000X
CO28923174400000X
CO36090174400000X
CO40932174400000X
CO20778174400000X
CO41037174400000X
CO27491174400000X
CO35006174400000X
CO14504174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC18604Medicare PIN