Healthcare Provider Details
I. General information
NPI: 1669004792
Provider Name (Legal Business Name): CATHOLIC HEALTH INITIATIVES COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/06/2020
Last Update Date: 07/23/2020
Certification Date: 07/23/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
360 PEAK ONE DR STE 300
FRISCO CO
80443
US
IV. Provider business mailing address
PO BOX 800022
KANSAS CITY MO
64180-0022
US
V. Phone/Fax
- Phone: 970-668-6305
- Fax: 970-668-6301
- Phone: 800-953-0104
- Fax: 303-765-6670
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
ANGELA
J
SKINNER
Title or Position: ADMINISTRATOR, OMA
Credential:
Phone: 303-673-7175