1114559457 NPI number — CATHOLIC HEALTH INITIATIVES COLORADO

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114559457 NPI number — CATHOLIC HEALTH INITIATIVES COLORADO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CATHOLIC HEALTH INITIATIVES COLORADO
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CENTURA HEALTH EMERGENCY AND URGENT CARE - AVON
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114559457
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/10/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 800022
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64180-0022
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-953-0104
Provider Business Mailing Address Fax Number:
303-765-6670

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
50 BUCK CREEK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AVON
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81620
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-668-7000
Provider Business Practice Location Address Fax Number:
970-668-7001
Provider Enumeration Date:
02/05/2020

Additional Information

Authorized Official

Authorized Official Last Name:
CARPENTER
Authorized Official First Name:
DEBRA
Authorized Official Middle Name:
Authorized Official Title or Position:
VP, AMBULATORY SERVICES
Authorized Official Telephone Number:
303-765-6998

Provider Taxonomy Codes

  • Taxonomy code: 261QE0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QU0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1033572615 . This is a "OLD NPI" identifier . This identifiers is of the category "OTHER".




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