Healthcare Provider Details
I. General information
NPI: 1215236500
Provider Name (Legal Business Name): CATHOLIC HEALTH INITIATIVES COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/25/2011
Last Update Date: 09/16/2020
Certification Date: 09/16/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10 PURGATORY BLVD
DURANGO CO
81301-0000
US
IV. Provider business mailing address
PO BOX 800022
KANSAS CITY MO
64180-0022
US
V. Phone/Fax
- Phone: 970-259-4553
- Fax: 970-247-0925
- Phone: 800-953-0104
- Fax: 303-765-6670
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
ANGELA
J
SKINNER
Title or Position: ADMINISTRATOR, OMA
Credential:
Phone: 303-673-7175