Healthcare Provider Details

I. General information

NPI: 1568633303
Provider Name (Legal Business Name): PORTERCARE ADVENTIST HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2008
Last Update Date: 07/23/2020
Certification Date: 07/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2555 S DOWNING ST FL 1
DENVER CO
80210-5856
US

IV. Provider business mailing address

PO BOX 801106
KANSAS CITY MO
64180-1106
US

V. Phone/Fax

Practice location:
  • Phone: 303-316-6677
  • Fax: 303-316-5004
Mailing address:
  • Phone: 800-953-0104
  • Fax: 303-765-6670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANGELA J SKINNER
Title or Position: ADMINISTRATOR, OMA
Credential:
Phone: 303-673-7175