Basic Information
| Provider Information | |||||||||
| NPI: | 1619013448 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GREENWOOD PEDIATRICS PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9094 E MINERAL AVE | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | CENTENNIAL | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801127200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036943200 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9094 E MINERAL AVE | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | CENTENNIAL | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801127200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036943200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/29/2007 | ||||||||
| LastUpdateDate: | 11/20/2020 | ||||||||
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| AuthorizedOfficialLastName: | BECKER | ||||||||
| AuthorizedOfficialFirstName: | CHRISTINA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR OF BILLING | ||||||||
| AuthorizedOfficialTelephone: | 7206338580 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 11/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |
No ID Information.