Healthcare Provider Details

I. General information

NPI: 1720525124
Provider Name (Legal Business Name): SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2017
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 EXEMPLA CIR STE P1-142
LAFAYETTE CO
80026-3370
US

IV. Provider business mailing address

PO BOX 912960
DENVER CO
80291-2960
US

V. Phone/Fax

Practice location:
  • Phone: 303-689-6121
  • Fax: 303-689-6126
Mailing address:
  • Phone: 303-689-6121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPDO.1680000162
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MATT D HIGLEY
Title or Position: VP, PHARMACY SERVICES
Credential:
Phone: 801-609-8246