Provider Demographics
NPI:1598112294
Name:NWH MEDICAL CENTER INC.
Entity Type:Organization
Organization Name:NWH MEDICAL CENTER INC.
Other - Org Name:LOUISVILLE MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-666-7717
Mailing Address - Street 1:892 W SOUTH BOULDER RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-2453
Mailing Address - Country:US
Mailing Address - Phone:972-951-2256
Mailing Address - Fax:303-666-7746
Practice Address - Street 1:892 W SOUTH BOULDER RD STE 101
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-2453
Practice Address - Country:US
Practice Address - Phone:303-666-7717
Practice Address - Fax:303-666-7746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-23
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO7575480001Medicare NSC