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NPI Code Detail

MEDICARE: PORTERCARE ADVENTIST HEALTH SYSTEM

MEDICARE: PORTERCARE ADVENTIST HEALTH SYSTEM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063811008
Entity Type Code : Organization
Provider Name (Legal Business Name) : PORTERCARE ADVENTIST HEALTH SYSTEM
Provider Business Mailing Address
First Line : PO BOX 911244
Second Line :
City : DENVER
State : CO
Zip : 80291-1244
Country : US
Telephone Number : 303-643-1099
Fax Number : 303-643-1176
Provider Business Practice Location Address
First Line : 7233 CHURCH RANCH BLVD
Second Line :
City : WESTMINSTER
State : CO
Zip : 80021-4094
Country : US
Telephone Number : 303-925-4055
Fax Number : 303-925-4056
Authorized Official
Title or Position : ADMINISTRATOR OMA
Name : ANGELA SKINNER
Credential :
Telephone Number : 303-673-7175
Provider Enumeration Date : 08/15/2014
Last Update Date : 04/28/2016

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1972902914 — PORTERCARE ADVENTIST HEALTH SYSTEM
Practice Location Address:
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Practice Phone: 303-925-4050
Practice Fax: 303-925-4051

Directions to “PORTERCARE ADVENTIST HEALTH SYSTEM ” Practice Location

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