Provider Demographics
NPI:1831623842
Name:ECHCS VA MEDICAL CENTER
Entity type:Organization
Organization Name:ECHCS VA MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ACOS, AMBULATORY CARE SERVICE
Authorized Official - Prefix:
Authorized Official - First Name:SHABNAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-399-8020
Mailing Address - Street 1:1055 CLERMONT ST
Mailing Address - Street 2:AMBULATORY CARE (11B)
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3808
Mailing Address - Country:US
Mailing Address - Phone:303-399-8020
Mailing Address - Fax:303-393-5123
Practice Address - Street 1:1055 CLERMONT ST
Practice Address - Street 2:AMBULATORY CARE (11B)
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3808
Practice Address - Country:US
Practice Address - Phone:303-399-8020
Practice Address - Fax:303-393-5123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-17
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
COSHARAOATES05Medicare UPIN
SHARAOATES05Medicare PIN