Healthcare Provider Details
I. General information
NPI: 1366053209
Provider Name (Legal Business Name): CATHOLIC HEALTH INITIATIVES COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/13/2020
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6071 E WOODMEN RD STE 225
COLORADO SPRINGS CO
80923-2611
US
IV. Provider business mailing address
PO BOX 800022
KANSAS CITY MO
64180-0022
US
V. Phone/Fax
- Phone: 719-571-7130
- Fax: 719-571-7152
- Phone: 800-953-0104
- Fax: 303-765-6670
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
MELISSA
THOMAS
Title or Position: ADMINISTRATOR OMA
Credential:
Phone: 303-673-7124