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Organization

MEMORIAL HEALTH SYSTEM

Active
Parent organization
MEMORIAL HEALTH SYSTEM
Other names
Memorial Physician Network- Pediatirc Surgery
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
1725 E BOULDER ST, SUITE 104, COLORADO SPRINGS, CO 80909-5768
(719) 365-9951
Mailing address
1725 E BOULDER ST, SUITE 104, COLORADO SPRINGS, CO 80909-5768
(719) 365-9951

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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