Provider Demographics
NPI:1609916741
Name:HCA-HEALTHONE, LLC
Entity Type:Organization
Organization Name:HCA-HEALTHONE, LLC
Other - Org Name:DENVER INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JAC
Authorized Official - Middle Name:
Authorized Official - Last Name:CONNELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-320-2035
Mailing Address - Street 1:4545 E 9TH AVE
Mailing Address - Street 2:SUITE 630
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3901
Mailing Address - Country:US
Mailing Address - Phone:303-320-2929
Mailing Address - Fax:303-320-2767
Practice Address - Street 1:4545 E 9TH AVE
Practice Address - Street 2:SUITE 630
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3901
Practice Address - Country:US
Practice Address - Phone:303-320-2929
Practice Address - Fax:303-320-2767
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HCA-HEALTHONE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-07
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCI1305OtherRAILROAD MEDICARE
CO04021853Medicaid
COC224008Medicare PIN