Organization
MEMORIAL HEALTH SYSTEM
Active
Parent organization
MEMORIAL HEALTH SYSTEM
Other names
Memorial Physician Network - Pediatric Subspecialty
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEMORIAL HEALTH SYSTEM
Authorized official
MARY JO YANTIS (VICE PRESIDENT)
(719) 365-9951
Entity
Organization
Contact information
Practice address
2121 E LA SALLE ST, COLORADO SPRINGS, CO 80909-2270
(719) 354-9951
Mailing address
2121 E LA SALLE ST, COLORADO SPRINGS, CO 80909-2270
(719) 354-9951
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
05/06/2010
Last updated
06/16/2010
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