Healthcare Provider Details

I. General information

NPI: 1598833329
Provider Name (Legal Business Name): KAISER FOUNDATION HEALTH PLAN OF COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10400 E ALAMEDA AVE
DENVER CO
80247-5104
US

IV. Provider business mailing address

10400 E ALAMEDA AVE
DENVER CO
80247-5104
US

V. Phone/Fax

Practice location:
  • Phone: 303-360-1280
  • Fax: 303-360-1287
Mailing address:
  • Phone: 303-360-1280
  • Fax: 303-360-1287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336M0003X
TaxonomyManaged Care Organization Pharmacy
License Number153
License Number StateCO

VIII. Authorized Official

Name: DENESE CLARK
Title or Position: REGIONAL ADMINISTRATOR
Credential:
Phone: 303-326-6717