Provider Demographics
NPI:1508469875
Name:PARTNERS IN PEDIATRICS, P.C.
Entity Type:Organization
Organization Name:PARTNERS IN PEDIATRICS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DEPARTMENT SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:RACHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTGOMERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-796-4802
Mailing Address - Street 1:PO BOX 17982
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4074
Mailing Address - Country:US
Mailing Address - Phone:303-779-1172
Mailing Address - Fax:303-779-8553
Practice Address - Street 1:9785 MAROON CIR STE G104
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-5922
Practice Address - Country:US
Practice Address - Phone:303-779-1172
Practice Address - Fax:303-779-8553
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARTNERS IN PEDIATRICS MERIDIAN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-19
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000147422Medicaid