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General NPI Number Information
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NPI Number | 1255813671
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Entity Type | Organization
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Legal Business Name | CATHOLIC HEALTH INITIATIVES COLORADO
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Dates
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Enumeration Date | 09/01/2018
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Last Update Date | 09/01/2018
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Provider Practice Location Address
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Address Line | 314 SOUTH 6TH STREET
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City | MONTROSE
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State | CO
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Zip | 81401-5719
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Country | US
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Telephone | 970-764-9265
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Fax | 970-764-9279
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Provider Business Mailing Address
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Address Line | P.O. BOX 911057
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City | DENVER
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State | CO
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Zip | 80291-1057
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Country | US
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Telephone | 970-764-9265
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Fax | 970-764-9279
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Authorized Official
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Title or Position | ASSOCIATE ADMINISTRATOR OMA
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Name | GLENN PESHEK
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Credential |
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Telephone | 303-673-7164
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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