Provider Demographics
NPI:1750486924
Name:CARDIODIAGNOSTICS OF COLORADO SPRINGS, INC.
Entity Type:Organization
Organization Name:CARDIODIAGNOSTICS OF COLORADO SPRINGS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:K
Authorized Official - Last Name:BEARDSLEE
Authorized Official - Suffix:
Authorized Official - Credentials:RDCS, RVT
Authorized Official - Phone:719-623-2201
Mailing Address - Street 1:5225 N ACADEMY BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-4000
Mailing Address - Country:US
Mailing Address - Phone:719-444-3777
Mailing Address - Fax:719-444-3756
Practice Address - Street 1:5225 N ACADEMY BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-4000
Practice Address - Country:US
Practice Address - Phone:719-444-3777
Practice Address - Fax:719-444-3756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO30153OtherBLUE CROSS/BLUE SHIELD
CO04301537Medicaid
CO30153OtherBLUE CROSS/BLUE SHIELD