Provider Demographics
NPI:1003863150
Name:EXEMPLA, INC (ST. JOSEPH HOSPITAL)
Entity Type:Organization
Organization Name:EXEMPLA, INC (ST. JOSEPH HOSPITAL)
Other - Org Name:ESJH FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BORGSTROM
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:303-837-7111
Mailing Address - Street 1:8300 W 38TH AVE
Mailing Address - Street 2:2ND FLOOR, EPN CRED
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6005
Mailing Address - Country:US
Mailing Address - Phone:303-403-3880
Mailing Address - Fax:303-425-8111
Practice Address - Street 1:8300 W 38TH AVE
Practice Address - Street 2:2ND FLOOR, EPN CRED
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6005
Practice Address - Country:US
Practice Address - Phone:303-403-3880
Practice Address - Fax:303-425-8111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty