Provider Demographics
NPI:1689892366
Name:QUALITY WOMANS HEALTHCARE PC
Entity Type:Organization
Organization Name:QUALITY WOMANS HEALTHCARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BHAVANI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHILLARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-329-5519
Mailing Address - Street 1:4545 E 9TH AVE
Mailing Address - Street 2:SUITE 506
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3901
Mailing Address - Country:US
Mailing Address - Phone:303-329-5519
Mailing Address - Fax:720-941-8337
Practice Address - Street 1:4545 E 9TH AVE
Practice Address - Street 2:SUITE 506
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3901
Practice Address - Country:US
Practice Address - Phone:303-329-5519
Practice Address - Fax:720-941-8337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO44652174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07680066Medicaid
CO07680066Medicaid