# PORTERCARE ADVENTIST HEALTH SYSTEM

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Centura Health Physician Group Women's Health Boulder
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518348580
- **Authorized official:** ANGELA SKINNER (OMA / ADMINISTRATOR)
- **Authorized official phone:** (303) 643-0925

## Contact information

- **Practice address:** 805 S BROADWAY ST, SUITE 103, BOULDER, CO 80305-5971
- **Practice address phone:** (303) 649-3240
- **Practice address fax:** (720) 582-9903
- **Mailing address:** PO BOX 911244, DENVER, CO 80291-1244
- **Mailing address phone:** (303) 643-1040
- **Mailing address fax:** (303) 643-1176

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/15/2015
- **Last updated:** 06/15/2015