Provider Demographics
NPI:1437160587
Name:EMERGENCY FOOTCARE, PC
Entity Type:Organization
Organization Name:EMERGENCY FOOTCARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLINTON
Authorized Official - Middle Name:FAY
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:303-789-9255
Mailing Address - Street 1:601 E HAMPDEN AVE
Mailing Address - Street 2:SUITE 410
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-3781
Mailing Address - Country:US
Mailing Address - Phone:303-789-9255
Mailing Address - Fax:303-789-0135
Practice Address - Street 1:601 E HAMPDEN AVE STE 410
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2770
Practice Address - Country:US
Practice Address - Phone:303-789-9255
Practice Address - Fax:303-789-0135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPOD660261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC805963Medicare PIN
CO4616020001Medicare NSC
COV09881Medicare UPIN