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NPI Code Detail

MEDICARE: PORTERCARE ADVENTIST HEALTH SYSTEM

MEDICARE: PORTERCARE ADVENTIST HEALTH SYSTEM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician

General Provider Information

NPI Number : 1093124422
Entity Type Code : Organization
Provider Name (Legal Business Name) : PORTERCARE ADVENTIST HEALTH SYSTEM
Provider Business Mailing Address
First Line : PO BOX 911244
Second Line :
City : DENVER
State : CO
Zip : 80291-1244
Country : US
Telephone Number : 303-643-1040
Fax Number : 303-643-1176
Provider Business Practice Location Address
First Line : 7233 CHURCH RANCH BLVD
Second Line :
City : WESTMINSTER
State : CO
Zip : 80021-4094
Country : US
Telephone Number : 303-925-4020
Fax Number : 303-925-4021
Authorized Official
Title or Position : ADMINISTRATOR OMA
Name : ANGELA SKINNER
Credential :
Telephone Number : 303-643-0925
Provider Enumeration Date : 08/11/2014
Last Update Date : 09/25/2015

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Directions to “PORTERCARE ADVENTIST HEALTH SYSTEM ” Practice Location

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