Basic Information
Provider Information
NPI: 1710546080
EntityType: 2
ReplacementNPI:  
OrganizationName: MEDICAL CENTER OF THE ROCKIES
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7901 E LOWRY BLVD., F402, 3RD FLOOR
Address2:  
City: DENVER
State: CO
PostalCode: 80230
CountryCode: US
TelephoneNumber: 9702377000
FaxNumber:  
Practice Location
Address1: 5881 W 16TH ST
Address2:  
City: GREELEY
State: CO
PostalCode: 806342910
CountryCode: US
TelephoneNumber: 9703132700
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/11/2019
LastUpdateDate: 08/14/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: RIEBER
AuthorizedOfficialFirstName: CHRISTOPHER
AuthorizedOfficialMiddleName: DANIEL
AuthorizedOfficialTitleorPosition: UCHEALTH CFO
AuthorizedOfficialTelephone: 7208487836
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: MEDICAL CENTER OF THE ROCKIES
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261Q00000X  N Ambulatory Health Care FacilitiesClinic/Center 
282N00000X  Y HospitalsGeneral Acute Care Hospital 

No ID Information.


Home