Provider Demographics
NPI:1083444079
Name:INTERMOUNTAIN FRONT RANGE, INC.
Entity type:Organization
Organization Name:INTERMOUNTAIN FRONT RANGE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DENTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-425-2410
Mailing Address - Street 1:500 ELDORADO BLVD STE 4300
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-3564
Mailing Address - Country:US
Mailing Address - Phone:303-272-0566
Mailing Address - Fax:
Practice Address - Street 1:12911 W 40TH AVE
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80401-2696
Practice Address - Country:US
Practice Address - Phone:303-425-4500
Practice Address - Fax:303-755-2900
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTEGRITY HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Multi-Specialty