Healthcare Provider Details

I. General information

NPI: 1124120589
Provider Name (Legal Business Name): CATHOLIC HEALTH INITIATIVES COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 04/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 N HIGHWAY 67
WOODLAND PARK CO
80863
US

IV. Provider business mailing address

DEPARTMENT 1057
DENVER CO
80291-1057
US

V. Phone/Fax

Practice location:
  • Phone: 719-686-0551
  • Fax: 719-686-8863
Mailing address:
  • Phone: 303-486-5500
  • Fax: 303-486-5501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAMES ROBERT HARRIS
Title or Position: CEO PHYS ENTERPRISES
Credential:
Phone: 303-804-8119