Organization Name: | BANNER IMAGING ASSOCIATES OF NORTH COLORADO |
NPI Number: | 1851639900 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DENNIS DAHLEN (SR VP FINANCE) |
Mailing Address: | 201 14th St Wheatland |
State: | WY US |
Postal Code: | 822013201 |
Phone Number: | 9703506860 |
Fax Number: | 9703783828 |
NPI Enumeration Date: | 01/24/2013 |
NPI Last Update Date: | 01/29/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Radiology |
Taxonomy Definition: |