Provider Demographics
NPI:1952373953
Name:COLORADO PATHOLOGY CONSULTANTS PC
Entity Type:Organization
Organization Name:COLORADO PATHOLOGY CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:DOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-723-4736
Mailing Address - Street 1:14275 MIDWAY RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3614
Mailing Address - Country:US
Mailing Address - Phone:214-932-8018
Mailing Address - Fax:610-271-4245
Practice Address - Street 1:695 S BROADWAY
Practice Address - Street 2:SUITE100
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-4003
Practice Address - Country:US
Practice Address - Phone:303-899-6900
Practice Address - Fax:303-899-6999
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERIPATH INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-03
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO06D0511305291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO70860100Medicaid
ID1952373953Medicaid
NM86420038Medicaid
COCOM5008OtherBCBS
WY1952373953Medicaid
MT1952373953Medicaid
NC7001272Medicaid
UT1952373953Medicaid
KS200381880AMedicaid
CO08003212Medicaid
CO08003212Medicaid
NM86420038Medicaid