Healthcare Provider Details

I. General information

NPI: 1609658483
Provider Name (Legal Business Name): COLORADO WEST HEALTHCARE SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2023
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

688 23 1/2 ROAD
GRAND JUNCTION CO
81505
US

IV. Provider business mailing address

PO BOX 1687
GRAND JUNCTION CO
81502-1687
US

V. Phone/Fax

Practice location:
  • Phone: 970-644-3821
  • Fax: 970-644-3913
Mailing address:
  • Phone: 970-644-3821
  • Fax: 970-644-3913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: CHRISTIAN THOMAS
Title or Position: PRESIDENT/CEO
Credential:
Phone: 970-644-3011