Organization
PORTERCARE ADVENTIST HEALTH SYSTEM
Active
Other names
Centura Medical Group Primary Care Elizabeth, PREL PC ELIZABETH
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON TACHA (COO)
(303) 304-7752
Entity
Organization
Contact information
Practice address
240 ELIZABETH ST STE B, ELIZABETH, CO 80107-7546
(303) 269-2551
(303) 269-2552
Mailing address
PO BOX 801106, KANSAS CITY, MO 64180-1106
(800) 953-0104
(303) 765-6640
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/24/2020
Last updated
03/19/2024
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