Provider Demographics
NPI:1689382053
Name:CAPITOL HEIGHTS MEDICAL INC
Entity Type:Organization
Organization Name:CAPITOL HEIGHTS MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACISTS
Authorized Official - Phone:720-470-8856
Mailing Address - Street 1:1200 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-3440
Mailing Address - Country:US
Mailing Address - Phone:720-588-6478
Mailing Address - Fax:
Practice Address - Street 1:1200 MADISON ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-3440
Practice Address - Country:US
Practice Address - Phone:720-588-6478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-14
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty