Provider Demographics
NPI:1124324686
Name:RFUREY SA LLC
Entity type:Organization
Organization Name:RFUREY SA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:FUREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-445-4769
Mailing Address - Street 1:PO BOX 432
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80151-0432
Mailing Address - Country:US
Mailing Address - Phone:303-445-4769
Mailing Address - Fax:303-445-1837
Practice Address - Street 1:3280 WADSWORTH BLVD STE 100
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-4640
Practice Address - Country:US
Practice Address - Phone:303-232-8585
Practice Address - Fax:303-232-3304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-01
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty