Basic Information
Provider Information
NPI: 1538219944
EntityType: 2
ReplacementNPI:  
OrganizationName: UCHEALTH PIKES PEAK REGIONAL HOSPITAL
LastName:  
FirstName:  
MiddleName:  
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Credential:  
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Mailing Information
Address1: 7901 E LOWRY BLVD
Address2: F402, 3RD FLOOR
City: DENVER
State: CO
PostalCode: 802306510
CountryCode: US
TelephoneNumber: 7205531700
FaxNumber: 7205531754
Practice Location
Address1: 16420 W US HIGHWAY 24
Address2:  
City: WOODLAND PARK
State: CO
PostalCode: 808638760
CountryCode: US
TelephoneNumber: 7196879999
FaxNumber: 7196865725
Other Information
ProviderEnumerationDate: 01/11/2007
LastUpdateDate: 01/09/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: MATSON
AuthorizedOfficialFirstName: DOREEN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CFO, UCHEALTH SOUTHERN REGION
AuthorizedOfficialTelephone: 7193652062
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: UCHEALTH PIKES PEAK REGIONAL HOSPITAL
AuthorizedOfficialNamePrefix: MS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/09/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
275N00000X COY Hospital UnitsMedicare Defined Swing Bed Unit 

No ID Information.


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