Healthcare Provider Details
I. General information
NPI: 1346506045
Provider Name (Legal Business Name): CATHOLIC HEALTH INITIATIVES COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/06/2012
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 MERCADO ST SUITE 100
DURANGO CO
81301-7306
US
IV. Provider business mailing address
PO BOX 800022
KANSAS CITY MO
64180-0022
US
V. Phone/Fax
- Phone: 970-385-7977
- Fax: 970-385-6727
- Phone: 800-953-0104
- Fax: 303-765-6670
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RX0202X |
| Taxonomy | Medical Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
ANGELA
JO
SKINNER
Title or Position: ADMINISTRATOR OMA
Credential:
Phone: 720-667-7283