Provider Demographics
NPI: | 1649210188 |
---|---|
Name: | SCL HEALTH FRONT RANGE, INC |
Entity Type: | Organization |
Organization Name: | SCL HEALTH FRONT RANGE, INC |
Other - Org Name: | INTERMOUNTAIN HEALTH HOSPICE - DENVER |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | VP FINANCE |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ASHLEY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | DENTON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 303-425-2410 |
Mailing Address - Street 1: | 500 ELDORADO BLVD STE 4300 |
Mailing Address - Street 2: | |
Mailing Address - City: | BROOMFIELD |
Mailing Address - State: | CO |
Mailing Address - Zip Code: | 80021-3564 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 855-851-4127 |
Mailing Address - Fax: | 303-272-0390 |
Practice Address - Street 1: | 3210 LUTHERAN PKWY |
Practice Address - Street 2: | |
Practice Address - City: | WHEAT RIDGE |
Practice Address - State: | CO |
Practice Address - Zip Code: | 80033-6019 |
Practice Address - Country: | US |
Practice Address - Phone: | 303-403-7281 |
Practice Address - Fax: | 303-403-7295 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2006-06-06 |
Last Update Date: | 2024-03-05 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Single Specialty | |
Yes | 207RH0002X | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine | Group - Single Specialty |
No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Single Specialty | |
No | 207VM0101X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Maternal & Fetal Medicine | Group - Single Specialty |
No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Single Specialty | |
No | 208200000X | Allopathic & Osteopathic Physicians | Plastic Surgery | Group - Single Specialty | |
No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Single Specialty | |
No | 261QX0200X | Ambulatory Health Care Facilities | Clinic/Center | Oncology | Group - Single Specialty |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Single Specialty | |
No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Single Specialty |
No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Single Specialty |
No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Single Specialty |
No | 207RX0202X | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
CO | 04023271 | Medicaid | |
CO | C458238 | Medicare Oscar/Certification | |
CO | C163008 | Medicare Oscar/Certification |