Organization
PORTERCARE ADVENTIST HEALTH SYSTEM
Active
Other names
Centura Health Physician Group Church Ranch Senior Care
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA SKINNER (OMA ADMINISTRATOR)
(303) 673-7175
Entity
Organization
Contact information
Practice address
7233 CHURCH RANCH BLVD, WESTMINSTER, CO 80021-4094
(303) 925-4040
(303) 925-4041
Mailing address
PO BOX 911244, DENVER, CO 80291-1244
(303) 643-1099
(303) 643-1176
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
79788530
—
CO
Enumeration date
10/30/2014
Last updated
04/20/2016
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