Provider Demographics
NPI:1619100880
Name:CHARLES W. MAINS, M.D., INC
Entity Type:Organization
Organization Name:CHARLES W. MAINS, M.D., INC
Other - Org Name:COLORADO VASCULAR SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:W
Authorized Official - Last Name:MAINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-467-1400
Mailing Address - Street 1:3455 LUTHERAN PKWY
Mailing Address - Street 2:SUITE 290
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6028
Mailing Address - Country:US
Mailing Address - Phone:303-467-1400
Mailing Address - Fax:303-467-1467
Practice Address - Street 1:3455 LUTHERAN PKWY
Practice Address - Street 2:SUITE 290
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6028
Practice Address - Country:US
Practice Address - Phone:303-467-1400
Practice Address - Fax:303-467-1467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty