Healthcare Provider Details

I. General information

NPI: 1154259448
Provider Name (Legal Business Name): PORTERCARE ADVENTIST HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 3RD ST SE
LOVELAND CO
80537-6419
US

IV. Provider business mailing address

PO BOX 713425
CHICAGO IL
60677-4325
US

V. Phone/Fax

Practice location:
  • Phone: 303-778-5797
  • Fax: 303-778-5205
Mailing address:
  • Phone: 800-953-0104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RT0003X
TaxonomyTransplant Hepatology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JASON TACHA
Title or Position: COO
Credential:
Phone: 303-304-7752