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General NPI Number Information
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NPI Number | 1861782476
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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 | 04/15/2011
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 1000 SOUTHPARK DR
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City | LITTLETON
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State | CO
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Zip | 80120-5654
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Country | US
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Telephone | 303-744-1065
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Fax | 303-733-1699
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Provider Business Mailing Address
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Address Line | PO BOX 713425
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City | CHICAGO
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State | IL
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Zip | 60677-4325
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | MR. JASON TACHA
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Credential |
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Telephone | 303-304-7752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology 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 | 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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