CREEKSIDE CANCER CARE LLC NPI 1912137811

NPI Information

NPI: 1912137811
Provider Name: CREEKSIDE CANCER CARE LLC
Classification: Clinic/Center - 261QX0203X
Entity Type: Organization

Specialization: Oncology, Radiation

Address:
120 OLD LARAMIE TRL E
LAFAYETTE, CO
ZIP 80026
Phone: (303) 926-9800
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CREEKSIDE CANCER CARE LLC is an oncology and radiation clinic center in Lafayette, CO. CREEKSIDE CANCER CARE LLC NPI is 1912137811. The provider is registered as an organization entity type.

The provider's business location address is:

120 OLD LARAMIE TRL E
LAFAYETTE, CO
ZIP 80026-012
Phone: (303) 926-9800
Fax: (303) 926-9801

The provider's authorized official is Charles Kelley Simpson .
The authorized official title is Medical Director and has the following contact phone number (303) 926-9800.

The enumeration date for this NPI number is 7/27/2009 and was last updated on 10/18/2010.

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
1	261QX0203X	Clinic/Center	Oncology, Radiation			Yes

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
1	COB4795	OTHER	COLORADO	MEDICARE INDIVIDUAL AND GROUP PTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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