Organization
CCRM DONOR EGG BANK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE JEAN RAVECH (CHIEF MANAGED CARE OFFICER)
(860) 305-6640
Entity
Organization
Contact information
Practice address
10290 RIDGEGATE CIR, LONE TREE, CO 80124-5331
(303) 788-8300
(303) 788-8310
Mailing address
10290 RIDGEGATE CIR, LONE TREE, CO 80124-5331
(303) 788-8300
(303) 788-8310
Taxonomy
Speciality
Code
Description
License number
State
261QA0006X
Ambulatory Fertility Facility
Primary
—
—
Other
Enumeration date
06/17/2025
Last updated
06/17/2025
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