Provider Demographics
NPI:1134316854
Name:COLORADO HEART & BODY IMAGING
Entity type:Organization
Organization Name:COLORADO HEART & BODY IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANCHET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-433-8800
Mailing Address - Street 1:2490 W 26TH AVE
Mailing Address - Street 2:110 A
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-5314
Mailing Address - Country:US
Mailing Address - Phone:303-433-8800
Mailing Address - Fax:303-433-1366
Practice Address - Street 1:2490 W 26TH AVE
Practice Address - Street 2:110 A
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-5314
Practice Address - Country:US
Practice Address - Phone:303-433-8800
Practice Address - Fax:303-433-1366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO21205261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO227608Medicare UPIN