# INTERMOUNTAIN MEDICAL GROUP DENVER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** INTERMOUNTAIN FRONT RANGE, INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1811378037
- **Legal business name:** INTERMOUNTAIN FRONT RANGE, INC.
- **Authorized official:** LYNNETTE GREEN (INSURANCE REP)
- **Authorized official phone:** (303) 272-0811

## Contact information

- **Practice address:** 500 ELDORADO BLVD, BLDG 6, STE 6250, BROOMFIELD, CO 80021-3408
- **Practice address phone:** (303) 272-0811
- **Practice address fax:** (303) 272-0740
- **Mailing address:** 500 ELDORADO BLVD, BLDG 6, STE 6250, BROOMFIELD, CO 80021-3408
- **Mailing address phone:** (303) 272-0811
- **Mailing address fax:** (303) 272-0740

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | CO | Yes |

## Other

- **Enumeration date:** 06/12/2015
- **Last updated:** 07/12/2024