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General NPI Number Information
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NPI Number | 1720729411
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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 | 04/05/2022
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Last Update Date | 04/26/2022
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Provider Practice Location Address
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Address Line | 90 HEALTH PARK DR STE 350
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City | LOUISVILLE
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State | CO
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Zip | 80027-9742
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Country | US
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Telephone | 303-925-5068
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Fax | 303-925-5069
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Provider Business Mailing Address
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Address Line | PO BOX 801106
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City | KANSAS CITY
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State | MO
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Zip | 64180-1106
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Country | US
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Telephone | 800-953-0104
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Fax | 303-765-6670
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Authorized Official
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Title or Position | ADMINISTRATOR, OMA
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Name | MRS. ANGELA J 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 | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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