NPIMap

Organization Active NPI

Sisters of Charity of Leavenworth Health System Inc

  • Institutional Pharmacy
  • Lafayette, CO
National Provider Identifier
1720525124
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
Legal business name
SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC
Practice address
200 Exempla Cir Ste P1-142
Lafayette, CO 80026-3370
Phone
(303) 689-6121
Fax
(303) 689-6126
NPI assigned
Jan 23, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Matt D Higley
Title
VP, Pharmacy Services
Phone
(801) 609-8246

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PDO.1680000162 CO
Institutional Pharmacy 3336I0012X Primary

Addresses

Primary practice location

200 Exempla Cir Ste P1-142
Lafayette, CO 80026-3370

Mailing address

PO Box 912960
Denver, CO 80291-2960
Phone (303) 689-6121

Other identifiers 1

IdentifierTypeStateIssuer
2176193OtherPK

Other names 3

  • Intermountain Pharmacy #07 Doing business as
  • Intermountain Good Samaritan Pharmacy Other name
  • Intermountain Health Good Samaritan Pharmacy Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180327001089 CO Part B Supplier - Pharmacy 6901879964 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Denver, CO; Lafayette, CO; Wheat Ridge, CO

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Sisters of Charity of Leavenworth Health System Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778457600000",
    "number": "1720525124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 912960",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802912960",
            "telephone_number": "303-689-6121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 EXEMPLA CIR STE P1-142",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800263370",
            "telephone_number": "303-689-6121",
            "fax_number": "303-689-6126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-23",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A",
        "authorized_official_last_name": "HIGLEY",
        "authorized_official_first_name": "MATT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VP, PHARMACY SERVICES",
        "authorized_official_telephone_number": "801-609-8246"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CO",
            "license": "PDO.1680000162",
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2176193",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intermountain Pharmacy #07",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Intermountain Good Samaritan Pharmacy",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Intermountain Health Good Samaritan Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lafayette, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.