Provider Demographics
NPI:1932464815
Name:PHYSICIANS' CHOICE HOME CARE, INC.
Entity Type:Organization
Organization Name:PHYSICIANS' CHOICE HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEA
Authorized Official - Middle Name:A
Authorized Official - Last Name:STINSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:720-288-0322
Mailing Address - Street 1:3888 E MEXICO AVE UNIT 256
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-3817
Mailing Address - Country:US
Mailing Address - Phone:720-288-0322
Mailing Address - Fax:720-235-0249
Practice Address - Street 1:3888 E MEXICO AVE UNIT 256
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3817
Practice Address - Country:US
Practice Address - Phone:720-288-0322
Practice Address - Fax:720-235-0249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-07
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO04C322251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04C322OtherSTATE OF COLORADO HOME CARE LICENSE LICENSE