Healthcare Provider Details

I. General information

NPI: 1932332020
Provider Name (Legal Business Name): PORTERCARE ADVENTIST HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2009
Last Update Date: 01/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2555 S. DOWNING ST. SUITE 140
DENVER CO
80210
US

IV. Provider business mailing address

P.O. BOX 911244
DENVER CO
80291-1244
US

V. Phone/Fax

Practice location:
  • Phone: 303-765-6380
  • Fax: 303-778-5268
Mailing address:
  • Phone: 303-643-1100
  • Fax: 303-643-1176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ANGELA SKINNER
Title or Position: ADMINISTRATOR OMS
Credential:
Phone: 303-643-0925