Provider Demographics
NPI:1841582590
Name:CSU HEALTH NETWORK
Entity Type:Organization
Organization Name:CSU HEALTH NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ELWYN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-491-6602
Mailing Address - Street 1:600 SOUTH DR
Mailing Address - Street 2:HARTSHORN BUILDING
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80523-0001
Mailing Address - Country:US
Mailing Address - Phone:970-491-7121
Mailing Address - Fax:
Practice Address - Street 1:600 SOUTH DR
Practice Address - Street 2:HARTSHORN BUILDING
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80523-0001
Practice Address - Country:US
Practice Address - Phone:970-491-7121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COLORADO STATE UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-05-12
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health