Provider Demographics
NPI:1699747857
Name:DENVER NMR, INC
Entity type:Organization
Organization Name:DENVER NMR, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:H
Authorized Official - Last Name:LORTSCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-623-5701
Mailing Address - Street 1:PO BOX 140097
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:CO
Mailing Address - Zip Code:80214-0097
Mailing Address - Country:US
Mailing Address - Phone:303-623-5701
Mailing Address - Fax:720-932-9109
Practice Address - Street 1:4231 W 16TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-1335
Practice Address - Country:US
Practice Address - Phone:303-623-5701
Practice Address - Fax:720-932-9109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-02
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04210407Medicaid
COCT7208Medicare PIN
COW14413Medicare UPIN
CO04210407Medicaid