Provider Demographics
NPI:1194921411
Name:REGENTS OF THE UNIVERSITY OF COLORADO
Entity type:Organization
Organization Name:REGENTS OF THE UNIVERSITY OF COLORADO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DEAN COLLEGE OF NURSING
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, RN
Authorized Official - Phone:303-724-1679
Mailing Address - Street 1:4107-B S. FEDERAL BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-4316
Mailing Address - Country:US
Mailing Address - Phone:303-315-6150
Mailing Address - Fax:303-783-9978
Practice Address - Street 1:4107B S. FEDERAL BOULEVARD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110-4316
Practice Address - Country:US
Practice Address - Phone:303-315-6150
Practice Address - Fax:303-783-9978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-24
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO64508561Medicaid