Provider Demographics
NPI:1619344017
Name:IRN INTERNATIONAL CORP.
Entity Type:Organization
Organization Name:IRN INTERNATIONAL CORP.
Other - Org Name:IRN HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:INESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVOSELSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-691-9999
Mailing Address - Street 1:6630 E HAMPDEN AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-3004
Mailing Address - Country:US
Mailing Address - Phone:303-691-9999
Mailing Address - Fax:303-691-9994
Practice Address - Street 1:6630 E HAMPDEN AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-3004
Practice Address - Country:US
Practice Address - Phone:303-691-9999
Practice Address - Fax:303-691-9994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-01
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1004TW251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04141446Medicaid