| Lakehurst Medical Center | |
|
4535 S Kipling St Littleton CO 80127-1139 | |
| (303) 973-0798 | |
| (303) 973-0314 |
| Full Name | Lakehurst Medical Center |
|---|---|
| Speciality | General Practice |
| Location | 4535 S Kipling St, Littleton, Colorado |
| Authorized Official Name and Position | Debi Shaklee (OFFICE MANAGER) |
| Authorized Official Contact | 3039730798 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakehurst Medical Center 4535 S Kipling St Littleton CO 80127-1139 Ph: (303) 973-0798 | Lakehurst Medical Center 4535 S Kipling St Littleton CO 80127-1139 Ph: (303) 973-0798 |
| NPI Number | 1700920386 |
|---|---|
| Provider Enumeration Date | 02/16/2007 |
| Last Update Date | 07/13/2010 |
| Medicare PECOS PAC ID | 4789678640 |
|---|---|
| Medicare Enrollment ID | O20040413000946 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700920386 | NPI | - | NPPES |
| 28856546 | Medicaid | CO | |
| 75424 | Other | CO | LAKEHURST MEDICAL CENTER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 18797 (Colorado) | Primary |
| Provider Name | Charles H Goldstein |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649256041 PECOS PAC ID: 1254301526 Enrollment ID: I20040727000142 |
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