Healthcare Provider Details

I. General information

NPI: 1770785131
Provider Name (Legal Business Name): HIGH COUNTRY HEALTH CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 03/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 TANGLEWOOD LANE STE. W-3
SILVERTHORNE CO
80498
US

IV. Provider business mailing address

PO BOX 911416
DENVER CO
80291-1416
US

V. Phone/Fax

Practice location:
  • Phone: 970-668-1791
  • Fax: 970-668-1792
Mailing address:
  • Phone: 866-352-7366
  • Fax: 970-668-6546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: KAREN COLDAGELLI
Title or Position: ADMINISTRATIVE ASSISTANT
Credential:
Phone: 970-668-1791