Basic Information
| Provider Information | |||||||||
| NPI: | 1194735001 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HIGH STREET PRIMARY CARE CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1801 HIGH ST | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802181307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038692160 | ||||||||
| FaxNumber: | 3038692544 | ||||||||
| Practice Location | |||||||||
| Address1: | 1801 HIGH ST | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802181307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038692160 | ||||||||
| FaxNumber: | 3038692544 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | RIFKIN | ||||||||
| AuthorizedOfficialFirstName: | JULIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CLINIC MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 3038692160 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RA0000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Adolescent Medicine |
No ID Information.