CCCRIC LLC NPI 1760814644

NPI Information

  • NPI: 1760814644
  • Provider Name: CCCRIC LLC
  • Classification: Internal Medicine - 207RH0003X
  • Specialization: Hematology & Oncology
  • Entity Type: Organization
  • Address: 799 E HAMPDEN AVE STE 500
    ENGLEWOOD, CO
    ZIP 80113
  • Phone: (303) 788-8675

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NPI Details

CCCRIC LLC is a hematology and oncology internal medicine in Englewood, CO. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. CCCRIC LLC NPI is 1760814644. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

799 E HAMPDEN AVE STE 500
ENGLEWOOD, CO
ZIP 80113-777
Phone: (303) 788-8675
Fax: (303) 788-8489

The provider's authorized official is Janice Halvorson .
The authorized official title is Practice Administrator and has the following contact phone number (303) 788-8675.

The enumeration date for this NPI number is 8/2/2013 and was last updated on 5/12/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RH0003XInternal MedicineHematology & OncologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
168524374MEDICAIDCOLORADO
2330948MEDICARE PINCOLORADO

What is NPI?

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This page was last updated on: 3/30/2025

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