Pediatric Associates Of Canon City, Prof. Llc
LBN: Pediatric Associates Of Canon City, Prof. Llc
Pediatric Associates Of Canon City, Prof. Llc is an health care organization with primary practice located at 1335 Phay Ave Suite A, Canon City CO 81212-2334. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as the primary health care specialty.
Pediatric Associates Of Canon City, Prof. Llc can be contacted via phone (719) 269-1727, or through Noland, Roger Deane via phone (719) 269-1727.
Contact Information
Primary practice address
1335 Phay Ave Suite A
Canon City CO 81212-2334
Phone: (719) 269-1727
Fax: (719) 269-1730
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 2080A0000X | 23117 | Colorado |
Profile Details
| NPI number | 1457498131 |
|---|---|
| LBN Legal business name | Pediatric Associates Of Canon City, Prof. Llc |
| DBA Doing business as | |
| Authorized official | Noland, Roger Deane |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 31st, 2007 |
| Last updated | Aug 22nd, 2020 - about 5 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457498131 | NPPES |
| Colorado | MEDICAID | 05638655 | |
| Colorado | MEDICAID | 01271139 |
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