Provider Demographics
NPI:1578197646
Name:RED ROCKS PEDIATRICS, PC
Entity Type:Organization
Organization Name:RED ROCKS PEDIATRICS, PC
Other - Org Name:INDIAN CREST PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JODY
Authorized Official - Middle Name:
Authorized Official - Last Name:KARRASCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-422-7677
Mailing Address - Street 1:7975 ALLISON WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005-4428
Mailing Address - Country:US
Mailing Address - Phone:303-422-7677
Mailing Address - Fax:303-422-6029
Practice Address - Street 1:7975 ALLISON WAY STE 100
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005-4428
Practice Address - Country:US
Practice Address - Phone:303-422-7677
Practice Address - Fax:303-422-6029
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RED ROCKS PEDIATRICS PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-27
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty