Provider Demographics
NPI:1063805943
Name:NORTH COLORADO SPINE CENTER LLC DME
Entity type:Organization
Organization Name:NORTH COLORADO SPINE CENTER LLC DME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:DHUPAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-353-5959
Mailing Address - Street 1:6200 W 9TH ST
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-4462
Mailing Address - Country:US
Mailing Address - Phone:970-353-5959
Mailing Address - Fax:970-353-5967
Practice Address - Street 1:6200 W 9TH ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-4462
Practice Address - Country:US
Practice Address - Phone:970-353-5959
Practice Address - Fax:970-353-5967
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH COLORADO SPINE CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies