Provider Demographics
NPI:1871915652
Name:CHRISTOPHER G GRIFFITH CRNA LLC
Entity type:Organization
Organization Name:CHRISTOPHER G GRIFFITH CRNA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:G
Authorized Official - Last Name:GRIFFITH
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:303-680-4230
Mailing Address - Street 1:14773 E BELLEWOOD PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-2231
Mailing Address - Country:US
Mailing Address - Phone:303-680-4230
Mailing Address - Fax:
Practice Address - Street 1:14773 E BELLEWOOD PL
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-2231
Practice Address - Country:US
Practice Address - Phone:303-680-4230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO60820207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO10379568Medicaid