Organization · NPI-2

Portercare Adventist Health System

Otolaryngology · Castle Rock, CO

NPI number1376970012
StatusActive
Last updated in NPPESApr 28, 2016

Details

NPI
1376970012
Entity type
Organization (NPI-2)
Legal business name
Portercare Adventist Health System
Organization subpart
No
Enumeration date
Sep 26, 2013
Last updated
Apr 28, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Y00000X Otolaryngology––Yes

Other names

  • Centura Health Physician Group Castle Rock Ent (Doing Business As)

Practice location

2352 Meadows Blvd
Suite 300
Castle Rock, CO 80109-8406

Phone 720-455-3800 · Fax 720-455-3801

Mailing address

Po Box 911244
Denver, CO 80291-1244

Phone 303-643-1099 · Fax 303-643-1176

Authorized official

Angela Skinner
Oma Administrator
3036737175

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