Provider Demographics
NPI:1558402933
Name:HCA-HEALTHONE, LLC DBA ROSE FAMILY MEDICINE CENTER
Entity type:Organization
Organization Name:HCA-HEALTHONE, LLC DBA ROSE FAMILY MEDICINE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-527-5008
Mailing Address - Street 1:2149 S HOLLY ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-5601
Mailing Address - Country:US
Mailing Address - Phone:303-584-7900
Mailing Address - Fax:303-584-7960
Practice Address - Street 1:2149 S HOLLY ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-5601
Practice Address - Country:US
Practice Address - Phone:303-584-7900
Practice Address - Fax:303-584-7960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CODA7385Medicare PIN
COC248308Medicare PIN