Provider Demographics
NPI:1700925120
Name:EASTERN COLORADO HEALTH CARE SYSTEM
Entity Type:Organization
Organization Name:EASTERN COLORADO HEALTH CARE SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF HEALTH INFORMATION OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLAREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-399-8020
Mailing Address - Street 1:4530 S VERBENA ST UNIT 316
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-2537
Mailing Address - Country:US
Mailing Address - Phone:303-771-5821
Mailing Address - Fax:
Practice Address - Street 1:1055 CLERMONT ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3808
Practice Address - Country:US
Practice Address - Phone:303-399-8020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO13911286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
COF70026Medicare ID - Type Unspecified
COD22521Medicare UPIN