Provider Demographics
NPI:1083461438
Name:PORTERCARE ADVENTIST HEALTH SYSTEM
Entity type:Organization
Organization Name:PORTERCARE ADVENTIST HEALTH SYSTEM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-269-4014
Mailing Address - Street 1:6069 S SOUTHLANDS PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-5316
Mailing Address - Country:US
Mailing Address - Phone:303-381-4440
Mailing Address - Fax:
Practice Address - Street 1:6069 S SOUTHLANDS PKWY STE 100
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-5316
Practice Address - Country:US
Practice Address - Phone:303-381-4440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PORTERCARE ADVENTIST HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-03
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography
Yes282N00000XHospitalsGeneral Acute Care Hospital