Healthcare Provider Details

I. General information

NPI: 1972981462
Provider Name (Legal Business Name): PORTERCARE ADVENTIST HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2015
Last Update Date: 04/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2535 S DOWNING ST SUITE 180
DENVER CO
80210-5847
US

IV. Provider business mailing address

PO BOX 911244
DENVER CO
80291-1244
US

V. Phone/Fax

Practice location:
  • Phone: 303-925-4540
  • Fax: 303-925-4541
Mailing address:
  • Phone: 303-643-1099
  • Fax: 303-643-1176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: ANGELA SKINNER
Title or Position: OMA / ADMINISTRATOR
Credential:
Phone: 303-673-7175