Healthcare Provider Details
I. General information
NPI: 1841352911
Provider Name (Legal Business Name): CATHOLIC HEALTH INITIATIVES COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/15/2006
Last Update Date: 12/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
145 PARSENN RD
WINTER PARK CO
80482
US
IV. Provider business mailing address
DEPT 1057
DENVER CO
80291-1057
US
V. Phone/Fax
- Phone: 970-726-8066
- Fax: 970-726-4941
- Phone: 303-486-5504
- Fax: 303-486-5502
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
ROBERT
HARRIS
SR.
Title or Position: CEO PHYSICIAN ENTERPRISES
Credential:
Phone: 303-804-8119