Basic Information
| Provider Information | |||||||||
| NPI: | 1972069375 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COLORADO SENIOR CARE SERVICES, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1431 CENTERPOINT BLVD | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379321984 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8652935676 | ||||||||
| FaxNumber: | 8652913239 | ||||||||
| Practice Location | |||||||||
| Address1: | 1400 S POTOMAC ST STE 150 | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800124541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033064329 | ||||||||
| FaxNumber: | 3036958627 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/11/2019 | ||||||||
| LastUpdateDate: | 02/11/2019 | ||||||||
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| AuthorizedOfficialLastName: | HOLLOWAY | ||||||||
| AuthorizedOfficialFirstName: | KIMBERLY | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | DIR OF PROVIDER AND PATIENT SERVICE | ||||||||
| AuthorizedOfficialTelephone: | 8652935676 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0300X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine |
No ID Information.