Provider Demographics
NPI:1336361096
Name:DENVER ENDOCRINOLOGY, DIABETES AND THYROID CENTER, PC
Entity Type:Organization
Organization Name:DENVER ENDOCRINOLOGY, DIABETES AND THYROID CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:GERARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-321-2644
Mailing Address - Street 1:601 E HAMPDEN AVE
Mailing Address - Street 2:SUITE 560
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-3781
Mailing Address - Country:US
Mailing Address - Phone:303-321-2644
Mailing Address - Fax:
Practice Address - Street 1:799 E HAMPDEN AVE STE 525
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2786
Practice Address - Country:US
Practice Address - Phone:303-321-2644
Practice Address - Fax:303-321-2446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO41235240Medicaid
CODN6181OtherRAILROAD MEDICARE
CODED41674OtherBLUE CROSS BLUE SHIELD
COC809722Medicare PIN