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General NPI Number Information
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NPI Number | 1801077078
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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 | 11/16/2007
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Last Update Date | 02/09/2009
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Provider Practice Location Address
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Address Line | 90 HEALTH PARK DR SUITE 320
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City | LOUISVILLE
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State | CO
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Zip | 80027-9757
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Country | US
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Telephone | 303-661-4316
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Fax | 303-661-4345
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Provider Business Mailing Address
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Address Line | DEPARTMENT 1244
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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 | 303-486-5504
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Fax | 303-486-5502
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES BOYLE
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Credential |
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Telephone | 303-778-5294
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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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