Provider Demographics
NPI:1720646250
Name:ALLPRIA HEALTHCARE
Entity type:Organization
Organization Name:ALLPRIA HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-834-7246
Mailing Address - Street 1:PO BOX 370832
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-0832
Mailing Address - Country:US
Mailing Address - Phone:833-834-7246
Mailing Address - Fax:720-502-5271
Practice Address - Street 1:10700 E BETHANY DR STE 104
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2625
Practice Address - Country:US
Practice Address - Phone:833-834-7246
Practice Address - Fax:720-502-5271
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLPRIA HEALTHCARE CENTERS, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000162178Medicaid