Provider Demographics
NPI:1104087931
Name:PARTNERS IN PEDIATRICS PC
Entity type:Organization
Organization Name:PARTNERS IN PEDIATRICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DEPARTMENT SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:RACHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTGOMERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-796-4802
Mailing Address - Street 1:PO BOX 17982
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4074
Mailing Address - Country:US
Mailing Address - Phone:303-796-4802
Mailing Address - Fax:303-996-0695
Practice Address - Street 1:3801 E FLORIDA AVE STE 300
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-2571
Practice Address - Country:US
Practice Address - Phone:303-388-4256
Practice Address - Fax:303-388-7802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-24
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO86457560Medicaid