| NPI | 1104242700 |
|---|---|
| Doing Business As | OPTUM COLORADO SPRINGS - ROUNDHOUSE |
| Former Legal Business Name | COLORADO SPRINGS HEALTH PARTNERS LLC |
| Former Legal Business Name | DAVITA MEDICAL GROUP COLORADO SPRINGS LLC |
| Former Legal Business Name | OPTUMCARE COLORADO SPRINGS LLC |
| Entity Type | Organization |
| Authorized Contact | EMILY CASTILLO Associate Director Credentialing 702-579-3253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 261QE0002X Clinic/Center, Emergency Care | |
| 332900000X Non-Pharmacy Dispensing Site | |
| Enumeration Date | 2014-03-07 |
| Last Update Date | 2024-08-20 |