1881065704 NPI number — CATHOLIC HEALTH INITIATIVES COLORADO

Table of content: (NPI 1881065704)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881065704 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:
CENTURA HEALTH PHYSICIAN GROUP GASTROENTEROLOGY ORCHARD
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:
1881065704
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/15/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO 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:
888-269-7001
Provider Business Mailing Address Fax Number:
303-764-6640

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14300 ORCHARD PKWY
Provider Second Line Business Practice Location Address:
FLOOR 2 POD1
Provider Business Practice Location Address City Name:
WESTMINSTER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80023-9206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-627-4310
Provider Business Practice Location Address Fax Number:
720-627-4311
Provider Enumeration Date:
10/19/2015

Additional Information

Authorized Official

Authorized Official Last Name:
SKINNER
Authorized Official First Name:
ANGELA
Authorized Official Middle Name:
Authorized Official Title or Position:
OMA / ADMINISTRATOR
Authorized Official Telephone Number:
303-643-0925

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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