Organization · Type 2 NPI

Memorial Health System

Specialist · Colorado Springs, CO

NPI number 1164740700 Active

Practice location

2121 E La Salle St
Colorado Springs, CO 80909-2270

Specialties and licenses

Taxonomy	Code	License
Specialist Primary	174400000X	None listed

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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NPI record

NPI: 1164740700
Entity type: Organization (Type 2)
Issued: May 6, 2010
Last updated: Jun 16, 2010
Status: Active
Subpart: Yes of Memorial Health System

Other names

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Memorial Physician Network - Pediatric Subspecialty · doing business as

Authorized official

Mary Jo Yantis
Vice President
(719) 365-9951

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1164740700

Memorial Health System's National Provider Identifier is 1164740700, issued on May 6, 2010. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Colorado Springs, CO. The record was last updated on Jun 16, 2010.