Portercare Adventist Health System

Organization Active NPI Medical Oncology Physician · Louisville, CO

NPI 1831561109 · NPPES record last updated Dec 22, 2020

Key facts

NPI
1831561109
Entity type
Organization (NPI type 2)
Primary specialty
Medical Oncology Physician 207RX0202X
Legal business name
PORTERCARE ADVENTIST HEALTH SYSTEM
Practice address
80 Health Park Dr Ste 270
Louisville, CO 80027-4644
Phone
(303) 661-1860
Fax
(303) 661-1861
NPI assigned
Oct 27, 2015
Organization subpart
No

Authorized official

Name
Angela Skinner
Title
Oma / Administrator
Phone
(303) 673-7175

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20090115000327 CO Part B Supplier - Clinic/Group Practice 0941110886 Receives reassigned benefits from 869 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RX0202X Yes

Addresses

Primary practice location

80 Health Park Dr Ste 270
Louisville, CO 80027-4644

Mailing address

PO Box 911244
Denver, CO 80291-1244
Phone (888) 269-7001

Other names

  • MOAV MED ONC AVISTA Doing business as
  • Centura Health Physician Group Medical Oncology Avista Other name

Other providers in Louisville, CO

All providers in Louisville, CO · Medical Oncology Physician in Colorado

Sources for this page

Verify at the official NPI Registry.