Organization Name: | FIRESTONE MEDICAL CENTER LLC |
NPI Number: | 1417370230 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TIM FIELDING (CFO) |
Mailing Address: | 5965 Firestone Blvd Firestone |
State: | CO US |
Postal Code: | 805046607 |
Phone Number: | 9728996666 |
Fax Number: | 9728995954 |
NPI Enumeration Date: | 01/30/2014 |
NPI Last Update Date: | 11/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0002X |
License Number: | 18L575 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Emergency Care |
Taxonomy Definition: |