Provider Demographics
NPI:1790715084
Name:VILLA WOMEN'S CARE, PLLC
Entity Type:Organization
Organization Name:VILLA WOMEN'S CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:HALGRIMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-565-5700
Mailing Address - Street 1:3600 E ALAMEDA AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-3189
Mailing Address - Country:US
Mailing Address - Phone:303-565-5700
Mailing Address - Fax:303-565-5701
Practice Address - Street 1:3600 E ALAMEDA AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-3189
Practice Address - Country:US
Practice Address - Phone:303-565-5700
Practice Address - Fax:303-565-5701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO803190Medicare ID - Type Unspecified