Basic Information
Provider Information
NPI: 1629527494
EntityType: 2
ReplacementNPI:  
OrganizationName: CHER LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: HEALTH IMAGES AT LONGMONT
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8610 EXPLORER DR
Address2: SUITE 300
City: COLORADO SPRINGS
State: CO
PostalCode: 809201058
CountryCode: US
TelephoneNumber: 7199554332
FaxNumber: 7193585401
Practice Location
Address1: 1551 PROFESSIONAL LN
Address2: SUITE 175
City: LONGMONT
State: CO
PostalCode: 805016972
CountryCode: US
TelephoneNumber: 7199554332
FaxNumber: 7193585401
Other Information
ProviderEnumerationDate: 09/22/2016
LastUpdateDate: 09/22/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: JONES
AuthorizedOfficialFirstName: JEFF
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CFO
AuthorizedOfficialTelephone: 7199554332
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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