Provider Demographics
NPI:1588819353
Name:1ST IMMUNOLOGY AND INFUSION CENTER
Entity Type:Organization
Organization Name:1ST IMMUNOLOGY AND INFUSION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ESTER
Authorized Official - Middle Name:
Authorized Official - Last Name:BORIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-773-9000
Mailing Address - Street 1:7286 S YOSEMITE ST
Mailing Address - Street 2:SUITE 180
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-2204
Mailing Address - Country:US
Mailing Address - Phone:303-773-9000
Mailing Address - Fax:740-488-4149
Practice Address - Street 1:7286 S YOSEMITE ST
Practice Address - Street 2:SUITE 110
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-2204
Practice Address - Country:US
Practice Address - Phone:303-773-9000
Practice Address - Fax:720-488-4149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty