Provider Demographics
NPI:1053035758
Name:NATIONAL JEWISH PULMONARY ROSE
Entity type:Organization
Organization Name:NATIONAL JEWISH PULMONARY ROSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, MEDICAL STAFF SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-398-1581
Mailing Address - Street 1:4545 E 9TH AVE STE 370
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3913
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4545 E 9TH AVE STE 370
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3913
Practice Address - Country:US
Practice Address - Phone:303-388-4461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONAL JEWISH HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty