Provider Demographics
NPI:1972069375
Name:COLORADO SENIOR CARE SERVICES, P.C.
Entity Type:Organization
Organization Name:COLORADO SENIOR CARE SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR OF PROVIDER AND PATIENT SERVICE
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:P
Authorized Official - Last Name:HOLLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-293-5676
Mailing Address - Street 1:1431 CENTERPOINT BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37932-1984
Mailing Address - Country:US
Mailing Address - Phone:865-293-5676
Mailing Address - Fax:865-291-3239
Practice Address - Street 1:1400 S POTOMAC ST STE 150
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4541
Practice Address - Country:US
Practice Address - Phone:303-306-4329
Practice Address - Fax:303-695-8627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty