Healthcare Provider Details

I. General information

NPI: 1528699261
Provider Name (Legal Business Name): PORTERCARE ADVENTIST HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2020
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9205 S BROADWAY
HIGHLANDS RANCH CO
80129-5631
US

IV. Provider business mailing address

9205 S BROADWAY
HIGHLANDS RANCH CO
80129-5631
US

V. Phone/Fax

Practice location:
  • Phone: 303-649-3650
  • Fax: 303-649-3651
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JONATHAN PERRY
Title or Position: CFO
Credential:
Phone: 303-738-2628