Healthcare Provider Details

I. General information

NPI: 1902909237
Provider Name (Legal Business Name): CATHOLIC HEALTH INITIATIVES COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 04/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 E AGATE
GRANBY CO
80446
US

IV. Provider business mailing address

DEPT 1057
DENVER CO
80291-1057
US

V. Phone/Fax

Practice location:
  • Phone: 970-887-7400
  • Fax: 970-887-9305
Mailing address:
  • Phone: 303-486-5504
  • Fax: 303-486-5501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES ROBERT HARRIS
Title or Position: CEO PHYSICIAN ENTERPRISES
Credential:
Phone: 303-804-8119