Organization
CCCRIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANICE HALVORSON (PRACTICE ADMINISTRATOR)
(303) 788-8675
Entity
Organization
Contact information
Practice address
799 E HAMPDEN AVE STE 500, ENGLEWOOD, CO 80113-2777
(303) 788-8675
(303) 788-8489
Mailing address
799 E HAMPDEN AVE STE 500, ENGLEWOOD, CO 80113-2777
(303) 788-8675
(303) 788-8489
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
68524374
—
CO
Enumeration date
08/02/2013
Last updated
05/12/2014
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