Organization
PORTERCARE ADVENTIST HEALTH SYSTEM
Active
Other names
Centura Health Physician Group Castle Rock ENT
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA SKINNER (OMA ADMINISTRATOR)
(303) 673-7175
Entity
Organization
Contact information
Practice address
2352 MEADOWS BLVD, SUITE 300, CASTLE ROCK, CO 80109-8406
(720) 455-3800
(720) 455-3801
Mailing address
PO BOX 911244, DENVER, CO 80291-1244
(303) 643-1099
(303) 643-1176
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55239757
—
CO
Enumeration date
09/26/2013
Last updated
04/28/2016
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