Healthcare Provider Details

I. General information

NPI: 1487015988
Provider Name (Legal Business Name): CHILDREN'S HOSPITAL COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2016
Last Update Date: 10/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3455 LUTHERAN PKWY SUITE 230
WHEAT RIDGE CO
80033-6028
US

IV. Provider business mailing address

13123 E 16TH AVE B450
AURORA CO
80045-7106
US

V. Phone/Fax

Practice location:
  • Phone: 720-777-1370
  • Fax: 720-777-7257
Mailing address:
  • Phone: 720-777-2566
  • Fax: 720-777-7257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: LINDA MICHAEL
Title or Position: VP, CHIEF COMPLIANCE OFFICER
Credential:
Phone: 720-777-6537