Provider Demographics
NPI:1629214481
Name:CENTRAL STATS
Entity Type:Organization
Organization Name:CENTRAL STATS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RONA
Authorized Official - Middle Name:K
Authorized Official - Last Name:KNUDSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-472-2215
Mailing Address - Street 1:191 UNIVERSITY BLVD
Mailing Address - Street 2:STE 602
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-4613
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:191 UNIVERSITY BLVD
Practice Address - Street 2:STE 602
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-4613
Practice Address - Country:US
Practice Address - Phone:720-472-2215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38666207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty