MEDICARE: CHILDREN'S HOSPITAL COLORADO

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
1	282NC2000X	Children's Hospital

General Provider Information

NPI Number	:	1285395889
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILDREN'S HOSPITAL COLORADO

Provider Business Mailing Address
First Line	:	13123 E 16TH AVE # B450
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80045-7106
Country	:	US
Telephone Number	:	720-777-1234
Fax Number	:

Provider Business Practice Location Address
First Line	:	2375 TELSTAR DR STE 160
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-1043
Country	:	US
Telephone Number	:	719-305-1234
Fax Number	:

Authorized Official
Title or Position	:	VP, CHIEF COMPLIANCE OFFICER
Name	:	LINDA MICHAEL
Credential	:
Telephone Number	:	720-777-6537

Provider Enumeration Date	:	01/05/2022
Last Update Date	:	08/01/2022

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