Organization
VILLAGE MEDICAL CENTER PC
Active
Organization
VILLAGE MEDICAL CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOREL LARONN MD (PRESIDENT)
(303) 221-0000
Entity
Organization
Contact information
Practice address
5975 S QUEBEC ST, SUITE 150, CENTENNIAL, CO 80111-4564
(303) 221-0000
(303) 796-0304
Mailing address
5975 S QUEBEC ST, SUITE 150, CENTENNIAL, CO 80111-4564
(303) 221-0000
(303) 796-0304
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CE9649
RAILROAD MEDICARE
CO
01
—
VIU8608
BLUE SHIELD
CO
Enumeration date
06/19/2006
Last updated
04/08/2010
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