Basic Information
| Provider Information | |||||||||
| NPI: | 1578047536 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TRUE NORTH HEALTH NAVIGATION LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3455 RINGSBY CT STE 102 | ||||||||
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| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802164923 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 W COURT SQ STE 750 | ||||||||
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| City: | DECATUR | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300302545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3035001518 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2018 | ||||||||
| LastUpdateDate: | 09/17/2018 | ||||||||
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| AuthorizedOfficialLastName: | WAGNER | ||||||||
| AuthorizedOfficialFirstName: | ANDREW | ||||||||
| AuthorizedOfficialMiddleName: | JAMES | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF CLINICAL OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 6142264921 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | TRUE NORTH HEALTH NAVIGATION LLC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.