Organization
TAMARAC MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD JOE ROSENBAUM MD (LABORATORY DIRECTOR)
(303) 794-1083
Entity
Organization
Contact information
Practice address
3959 E ARAPAHOE RD, STE 100, CENTENNIAL, CO 80122-2070
(303) 794-1083
(303) 794-1093
Mailing address
3959 E ARAPAHOE RD, STE 100, CENTENNIAL, CO 80122-2070
(303) 794-1083
(303) 794-1093
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
06D0899927
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000100188
—
VA
05
—
00666014A
—
GA
05
—
0123731
—
MS
05
—
0153711
—
OH
01
—
06D0899927
CLIA NUMBER
—
05
—
08002669
—
CO
05
—
100245360A
—
KS
05
—
100759250A
—
OK
05
—
146949709
—
AR
05
—
1662275
—
LA
05
—
200061470
—
IN
05
—
343719100
—
MN
05
—
6705072000
—
WV
05
—
705766301
—
MO
05
—
C05800044
—
CA
05
—
J4463
—
NM
Enumeration date
07/12/2006
Last updated
03/21/2016
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