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General NPI Number Information
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NPI Number | 1063811008
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Entity Type | Organization
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Legal Business Name | PORTERCARE ADVENTIST HEALTH SYSTEM
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Dates
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Enumeration Date | 08/15/2014
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Last Update Date | 04/28/2016
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Provider Practice Location Address
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Address Line | 7233 CHURCH RANCH BLVD
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City | WESTMINSTER
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State | CO
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Zip | 80021-4094
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Country | US
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Telephone | 303-925-4055
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Fax | 303-925-4056
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Provider Business Mailing Address
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Address Line | PO BOX 911244
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City | DENVER
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State | CO
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Zip | 80291-1244
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Country | US
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Telephone | 303-643-1099
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Fax | 303-643-1176
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Authorized Official
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Title or Position | ADMINISTRATOR OMA
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Name | ANGELA SKINNER
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Credential |
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Telephone | 303-673-7175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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