1578866943 NPI number — CATHOLIC HEALTH INITIATIVES COLORADO

Table of content: BONITA JOY AVERY BA (NPI 1780941278)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578866943 NPI number — CATHOLIC HEALTH INITIATIVES COLORADO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CATHOLIC HEALTH INITIATIVES COLORADO
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
VASCULAR & ENDOVASCULAR SPECIALISTS OF COLORADO
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578866943
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/16/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 911057
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80291-1057
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-486-5401
Provider Business Mailing Address Fax Number:
303-486-5502

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11700 WEST 2ND PLACE
Provider Second Line Business Practice Location Address:
SUITE 210B
Provider Business Practice Location Address City Name:
LAKEWOOD
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80228
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-321-8090
Provider Business Practice Location Address Fax Number:
720-321-8091
Provider Enumeration Date:
12/07/2010

Additional Information

Authorized Official

Authorized Official Last Name:
WATSON
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
L
Authorized Official Title or Position:
C.M.O.
Authorized Official Telephone Number:
303-804-8119

Provider Taxonomy Codes

  • Taxonomy code: 2086S0129X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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