Provider Demographics
NPI:1770785131
Name:HIGH COUNTRY HEALTH CARE PC
Entity type:Organization
Organization Name:HIGH COUNTRY HEALTH CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLDAGELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-668-1791
Mailing Address - Street 1:PO BOX 911416
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80291-1416
Mailing Address - Country:US
Mailing Address - Phone:866-352-7366
Mailing Address - Fax:970-668-6546
Practice Address - Street 1:265 TANGLEWOOD LANE
Practice Address - Street 2:STE. W-3
Practice Address - City:SILVERTHORNE
Practice Address - State:CO
Practice Address - Zip Code:80498
Practice Address - Country:US
Practice Address - Phone:970-668-1791
Practice Address - Fax:970-668-1792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
240227500OtherWC US DEPT OF LABOR
COHIB5808OtherBCBS CO BLUE CARD CLAIMS
CO04017646Medicaid
COHIB5808OtherANTHEM BCBS
COM22040OtherWC RISKO INSURANCE
COHIB5808OtherANTHEM BCBS
COHIB5808OtherBCBS CO BLUE CARD CLAIMS
COHIB5808OtherANTHEM BCBS