Provider Demographics
NPI:1669420410
Name:TOTAL HEALTHCARE
Entity type:Organization
Organization Name:TOTAL HEALTHCARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RAMY
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-804-8189
Mailing Address - Street 1:DEPARTMENT 1322
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80291-1322
Mailing Address - Country:US
Mailing Address - Phone:303-486-5500
Mailing Address - Fax:303-486-5501
Practice Address - Street 1:2222 N NEVADA AVE
Practice Address - Street 2:STE 201
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6831
Practice Address - Country:US
Practice Address - Phone:719-776-5454
Practice Address - Fax:719-776-2516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO09470352Medicaid
COC451338Medicare PIN
CO451338Medicare ID - Type Unspecified