Provider Demographics
NPI:1518589480
Name:MSV FITZSIMONS, LLC
Entity Type:Organization
Organization Name:MSV FITZSIMONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:KORETKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-238-3838
Mailing Address - Street 1:13525 E 23RD AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-7450
Mailing Address - Country:US
Mailing Address - Phone:303-344-8282
Mailing Address - Fax:303-366-3016
Practice Address - Street 1:13525 E 23RD AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7450
Practice Address - Country:US
Practice Address - Phone:303-344-8282
Practice Address - Fax:303-366-3016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility