NPI | 1346632684 |
---|---|
Former Legal Business Name | DAVITA MEDICAL GROUP COLORADO SPRINGS LLC |
Former Legal Business Name | COLORADO SPRINGS HEALTH PARTNERS LLC |
Doing Business As | OPTUM COLORADO SPRINGS - MONUMENT |
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 | 208D00000X General Practice |
Additional Taxonomies | 207Q00000X Family Medicine |
207R00000X Internal Medicine | |
208000000X Pediatrics | |
332900000X Non-Pharmacy Dispensing Site | |
Enumeration Date | 2015-02-24 |
Last Update Date | 2024-08-20 |