Provider Demographics
NPI:1760556401
Name:CARE GROUP PC
Entity Type:Organization
Organization Name:CARE GROUP PC
Other - Org Name:THE CARE GROUP PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:LIVAUDAIS
Authorized Official - Last Name:GUILLORY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-343-3121
Mailing Address - Street 1:750 POTOMAC ST STE 111
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-6743
Mailing Address - Country:US
Mailing Address - Phone:303-343-3121
Mailing Address - Fax:888-268-3486
Practice Address - Street 1:750 POTOMAC ST STE 111
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-6743
Practice Address - Country:US
Practice Address - Phone:303-343-3121
Practice Address - Fax:888-268-3486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO26649207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCK2004OtherRAILROAD MEDICARE
COCK2004OtherRAILROAD MEDICARE