Provider Demographics
NPI:1861249500
Name:PIKES PEAK HOSPICE AND PALLIATIVE CARE GUIDE PROGRAM
Entity type:Organization
Organization Name:PIKES PEAK HOSPICE AND PALLIATIVE CARE GUIDE PROGRAM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-398-6226
Mailing Address - Street 1:8289 E LOWRY BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-7256
Mailing Address - Country:US
Mailing Address - Phone:303-398-6222
Mailing Address - Fax:
Practice Address - Street 1:2550 TENDERFOOT HILL ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3998
Practice Address - Country:US
Practice Address - Phone:719-633-3400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PIKES PEAK HOSPICE AND PALLIATIVE CARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-01
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty