Provider Demographics
NPI:1619912391
Name:DRY CREEK IMAGING LLC
Entity Type:Organization
Organization Name:DRY CREEK IMAGING LLC
Other - Org Name:DRY CREEK IMAGING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:COLEMAN
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-661-9200
Mailing Address - Street 1:PO BOX 300369
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-0369
Mailing Address - Country:US
Mailing Address - Phone:720-974-0323
Mailing Address - Fax:720-974-0370
Practice Address - Street 1:125 INVERNESS DR E
Practice Address - Street 2:SUITE 140
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-5137
Practice Address - Country:US
Practice Address - Phone:303-662-1674
Practice Address - Fax:303-708-0533
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOUCHSTONE MEDICAL IMAGING, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-18
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO67178871Medicaid
COC65543Medicare PIN