Provider Demographics
NPI:1801370465
Name:CASTLE ROCK CONCIERGE CARDIOLOGY, P.C.
Entity type:Organization
Organization Name:CASTLE ROCK CONCIERGE CARDIOLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:INA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-788-2232
Mailing Address - Street 1:1175 S PERRY ST STE 250
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-0017
Mailing Address - Country:US
Mailing Address - Phone:720-768-3456
Mailing Address - Fax:303-663-8250
Practice Address - Street 1:1175 S PERRY ST STE 250
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-0017
Practice Address - Country:US
Practice Address - Phone:720-768-3456
Practice Address - Fax:303-663-8250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty