Provider Demographics
NPI:1649295130
Name:UROLOGY CENTER OF THE ROCKIES, PC
Entity type:Organization
Organization Name:UROLOGY CENTER OF THE ROCKIES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:NARUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-484-6700
Mailing Address - Street 1:2315 E HARMONY RD
Mailing Address - Street 2:STE 140
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-8620
Mailing Address - Country:US
Mailing Address - Phone:970-484-6700
Mailing Address - Fax:970-484-5723
Practice Address - Street 1:2315 E HARMONY RD
Practice Address - Street 2:STE 140
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-8620
Practice Address - Country:US
Practice Address - Phone:970-484-6700
Practice Address - Fax:970-484-5723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04631040Medicaid
CO63104OtherBCBS
CO63104OtherBCBS
C63104Medicare PIN