Provider Demographics
NPI:1881680734
Name:INPATIENT MEDICINE SERVICE PC
Entity Type:Organization
Organization Name:INPATIENT MEDICINE SERVICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:303-781-8439
Mailing Address - Street 1:499 EAST HAMPDEN
Mailing Address - Street 2:#320
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2793
Mailing Address - Country:US
Mailing Address - Phone:303-781-8439
Mailing Address - Fax:303-781-3026
Practice Address - Street 1:499 EAST HAMPDEN
Practice Address - Street 2:#320
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2793
Practice Address - Country:US
Practice Address - Phone:303-781-8439
Practice Address - Fax:303-781-3026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-26
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO61683752Medicaid
CO61683752Medicaid