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General NPI Number Information
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NPI Number | 1780823740
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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 | 02/16/2009
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Last Update Date | 06/17/2011
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Provider Practice Location Address
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Address Line | 8671 S QUEBEC ST SUITE 220
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80130
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Country | US
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Telephone | 303-346-4444
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Fax | 303-346-4411
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Provider Business Mailing Address
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Address Line | DEPT 1244
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City | DENVER
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State | CO
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Zip | 80291-0001
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Country | US
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Telephone | 303-486-5500
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Fax | 303-486-5501
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Authorized Official
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Title or Position | VP
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Name | RENAE W PEMBERTON
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Credential |
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Telephone | 303-804-8124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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