Provider Demographics
NPI:1447343371
Name:CENTER FOR VOICE AND SWALLOWING SERVICES, LLC
Entity type:Organization
Organization Name:CENTER FOR VOICE AND SWALLOWING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:L
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-781-0404
Mailing Address - Street 1:9980 PARK MEADOWS DRIVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-8406
Mailing Address - Country:US
Mailing Address - Phone:303-781-0404
Mailing Address - Fax:303-781-0804
Practice Address - Street 1:9980 PARK MEADOWS DRIVE
Practice Address - Street 2:SUITE 201
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-8406
Practice Address - Country:US
Practice Address - Phone:303-781-0404
Practice Address - Fax:303-781-0804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO86685236Medicaid