Provider Demographics
NPI:1760650832
Name:FRANKTOWN FAMILY MEDICINE, LLC
Entity Type:Organization
Organization Name:FRANKTOWN FAMILY MEDICINE, LLC
Other - Org Name:INTEGRATIVE MEDICINE CENTERS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REINER
Authorized Official - Middle Name:G
Authorized Official - Last Name:KREMER
Authorized Official - Suffix:
Authorized Official - Credentials:NMD, PA-C
Authorized Official - Phone:303-688-1111
Mailing Address - Street 1:PO BOX 11
Mailing Address - Street 2:7601 EAST BURNING TREE DRIVE
Mailing Address - City:FRANKTOWN
Mailing Address - State:CO
Mailing Address - Zip Code:80116-0011
Mailing Address - Country:US
Mailing Address - Phone:303-688-1111
Mailing Address - Fax:720-459-7019
Practice Address - Street 1:7601 BURNING TREE DR
Practice Address - Street 2:
Practice Address - City:FRANKTOWN
Practice Address - State:CO
Practice Address - Zip Code:80116-9540
Practice Address - Country:US
Practice Address - Phone:303-688-1111
Practice Address - Fax:720-459-7019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-12
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA0003980363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCK0603Medicare PIN
COT60443Medicare UPIN