Healthcare Provider Details

I. General information

NPI: 1548393937
Provider Name (Legal Business Name): STATE OF COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 W OXFORD AVE
DENVER CO
80236-3108
US

IV. Provider business mailing address

3520 W OXFORD AVE
DENVER CO
80236-3108
US

V. Phone/Fax

Practice location:
  • Phone: 303-866-7080
  • Fax: 303-866-7088
Mailing address:
  • Phone: 719-546-4000
  • Fax: 719-546-4484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number0196
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JASON FOLBIGG
Title or Position: CFO
Credential:
Phone: 303-720-5413