# PORTERCARE ADVENTIST HEALTH SYSTEM

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Centura Health Physician Group Castle Rock ENT
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376970012
- **Authorized official:** ANGELA SKINNER (OMA ADMINISTRATOR)
- **Authorized official phone:** (303) 673-7175

## Contact information

- **Practice address:** 2352 MEADOWS BLVD, SUITE 300, CASTLE ROCK, CO 80109-8406
- **Practice address phone:** (720) 455-3800
- **Practice address fax:** (720) 455-3801
- **Mailing address:** PO BOX 911244, DENVER, CO 80291-1244
- **Mailing address phone:** (303) 643-1099
- **Mailing address fax:** (303) 643-1176

## Taxonomy

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

## Other

- **Enumeration date:** 09/26/2013
- **Last updated:** 04/28/2016