Organization
HEART CENTER OF THE ROCKIES CATH LAB LLC
Active
Organization
HEART CENTER OF THE ROCKIES CATH LAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALE RICHARDSON (ADMINISTRATOR)
(970) 297-6931
Entity
Organization
Contact information
Practice address
2500 ROCKY MOUNTAIN AVE, LOVELAND, CO 80538
(970) 624-1756
(970) 624-1792
Mailing address
2121 E HARMONY RD, STE 100, FORT COLLINS, CO 80528-3400
(970) 297-6866
(970) 297-6862
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
31863
CO
207RI0011X
Interventional Cardiology Physician
Primary
31863
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
25139347
—
CO
01
—
HE642103
ANTHEM BCBS
CO
Enumeration date
08/11/2005
Last updated
02/22/2008
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