Provider Demographics
NPI:1215633045
Name:CHRIESL INFUSION CENTERS LLC
Entity type:Organization
Organization Name:CHRIESL INFUSION CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-CRNA
Authorized Official - Phone:720-372-1205
Mailing Address - Street 1:1444 S POTOMAC ST STE 220
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4509
Mailing Address - Country:US
Mailing Address - Phone:720-400-7025
Mailing Address - Fax:720-400-7049
Practice Address - Street 1:8758 WOLFF CT STE 205
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-6904
Practice Address - Country:US
Practice Address - Phone:720-400-7025
Practice Address - Fax:720-400-7049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000189133Medicaid