# PORTERCARE ADVENTIST HEALTH SYSTEM

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CHPG Castle Rock ENT, CHPG SPC Metro A, ETRK ENT CRK
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336758838
- **Authorized official:** MRS. ANGELA J SKINNER (ADMINISTRATOR- OMA)
- **Authorized official phone:** (303) 673-7175

## Contact information

- **Practice address:** 2352 MEADOWS BLVD STE 300, CASTLE ROCK, CO 80109-8419
- **Practice address phone:** (303) 274-2544
- **Practice address fax:** (720) 274-2541
- **Mailing address:** PO BOX 801106, KANSAS CITY, MO 64180-1160
- **Mailing address phone:** (720) 455-3800
- **Mailing address fax:** (720) 455-3801

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | — | NULL | Yes |
| 207Y00000X | Otolaryngology Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/30/2020
- **Last updated:** 12/21/2020