| Pediatrics West, P.c. | |
|
3555 Lutheran Parkway Suite 200 Wheat Ridge CO 80033-6027 | |
| (720) 284-3700 | |
| (303) 467-0525 |
| Full Name | Pediatrics West, P.c. |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 3555 Lutheran Parkway, Wheat Ridge, Colorado |
| Authorized Official Name and Position | Tym C Johnson (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 7202843708 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatrics West, P.c. 3555 Lutheran Parkway Suite 200 Wheat Ridge CO 80033-6027 Ph: (720) 284-3700 | Pediatrics West, P.c. 3555 Lutheran Parkway Suite 200 Wheat Ridge CO 80033-6027 Ph: (720) 284-3700 |
| NPI Number | 1275559569 |
|---|---|
| Provider Enumeration Date | 07/14/2006 |
| Last Update Date | 06/12/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275559569 | NPI | - | NPPES |
| 08683778 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (Colorado) | Primary |
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