Provider Demographics
NPI:1275821753
Name:TOTAL HEALTHCARE
Entity Type:Organization
Organization Name:TOTAL HEALTHCARE
Other - Org Name:COLORADO SPINCECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:JARDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-475-9496
Mailing Address - Street 1:3030 N CIRCLE DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-1177
Mailing Address - Country:US
Mailing Address - Phone:719-475-9496
Mailing Address - Fax:719-471-7271
Practice Address - Street 1:DEPT 1322
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80291-1322
Practice Address - Country:US
Practice Address - Phone:719-475-9496
Practice Address - Fax:719-471-4448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-18
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC451338Medicare PIN