Provider Demographics
NPI: | 1619624897 |
---|---|
Name: | CATHOLIC HEALTH INITIATIVES COLORADO |
Entity type: | Organization |
Organization Name: | CATHOLIC HEALTH INITIATIVES COLORADO |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | ADMINISTRATOR OMA |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | ANGELA |
Authorized Official - Middle Name: | JO |
Authorized Official - Last Name: | SKINNER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 720-667-7283 |
Mailing Address - Street 1: | PO BOX 800022 |
Mailing Address - Street 2: | |
Mailing Address - City: | KANSAS CITY |
Mailing Address - State: | MO |
Mailing Address - Zip Code: | 64180-0022 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 800-953-0104 |
Mailing Address - Fax: | 303-675-6670 |
Practice Address - Street 1: | 1000 LINCOLN ST STE 203 |
Practice Address - Street 2: | |
Practice Address - City: | FORT MORGAN |
Practice Address - State: | CO |
Practice Address - Zip Code: | 80701-3290 |
Practice Address - Country: | US |
Practice Address - Phone: | 970-542-0390 |
Practice Address - Fax: | 970-542-0394 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2022-03-07 |
Last Update Date: | 2024-06-25 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty |