Provider Demographics
NPI:1780626069
Name:COLORADO WEST EMERGENCY PHYSICIANS, LLC
Entity type:Organization
Organization Name:COLORADO WEST EMERGENCY PHYSICIANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WESTIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:AMBERGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-372-2296
Mailing Address - Street 1:PO BOX 2026
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81502-2026
Mailing Address - Country:US
Mailing Address - Phone:970-298-1977
Mailing Address - Fax:
Practice Address - Street 1:2635 N 7TH ST
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-8209
Practice Address - Country:US
Practice Address - Phone:970-298-1977
Practice Address - Fax:970-298-2898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCN9173OtherRR
CO222008OtherBLUE CROSS BLUE SHIELD
CO004023693Medicaid
CO004023693Medicaid