Organization
CO PACS 2 PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA BAKERINK (PROVIDER ENROLLMENT DIRECTOR)
(865) 500-1325
Entity
Organization
Contact information
Practice address
14699 E HAMPDEN AVE, AURORA, CO 80014-3903
(303) 693-0111
Mailing address
1643 NW 136TH AVENUE, BUILDING H, SUITE 100 MSC 11607-001, SUNRISE, FL 33323-2857
(865) 500-1325
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
—
Other
Enumeration date
11/09/2021
Last updated
11/09/2021
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