Healthcare Provider Details
I. General information
NPI: 1114329745
Provider Name (Legal Business Name): CATHOLIC HEALTH INITIATIVES COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/26/2014
Last Update Date: 04/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1010 THREE SPRINGS BLVD SUITE 255
DURANGO CO
81301-8296
US
IV. Provider business mailing address
PO BOX 911057
DENVER CO
80291-1057
US
V. Phone/Fax
- Phone: 970-764-3780
- Fax: 970-764-3785
- Phone: 303-643-1099
- Fax: 303-643-1176
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RE0101X |
| Taxonomy | Endocrinology, Diabetes & Metabolism Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANGELA
SKINNER
Title or Position: OMA ADMINISTRATOR
Credential:
Phone: 303-673-7175