Provider Demographics
NPI:1629071758
Name:BRIGHTON COMMUNITY HOSPITAL ASSOCIATION
Entity Type:Organization
Organization Name:BRIGHTON COMMUNITY HOSPITAL ASSOCIATION
Other - Org Name:INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:STOEHR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-788-8460
Mailing Address - Street 1:1600 PRAIRIE CENTER PKWY
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-4006
Mailing Address - Country:US
Mailing Address - Phone:303-498-1600
Mailing Address - Fax:303-498-3629
Practice Address - Street 1:1600 PRAIRIE CENTER PARKWAY
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-4006
Practice Address - Country:US
Practice Address - Phone:303-498-1600
Practice Address - Fax:303-498-3629
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTEGRITY HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-05-23
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0557282N00000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO06-0004Medicare ID - Type Unspecified