Provider Demographics
NPI:1447935101
Name:MOUNTAIN PEAK PRIMARY CARE LLC
Entity type:Organization
Organization Name:MOUNTAIN PEAK PRIMARY CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:HADEE
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMADI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:720-427-5929
Mailing Address - Street 1:9450 E MISSISSIPPI AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-2427
Mailing Address - Country:US
Mailing Address - Phone:720-710-4933
Mailing Address - Fax:720-710-4746
Practice Address - Street 1:9450 E MISSISSIPPI AVE UNIT B
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80247-2427
Practice Address - Country:US
Practice Address - Phone:720-710-4933
Practice Address - Fax:720-710-4746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-20
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care