Healthcare Provider Details

I. General information

NPI: 1386675619
Provider Name (Legal Business Name): WASHINGTON COUNTY COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 06/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

482 ADAMS AVE
AKRON CO
80720-1149
US

IV. Provider business mailing address

482 ADAMS AVE
AKRON CO
80720-1149
US

V. Phone/Fax

Practice location:
  • Phone: 970-345-2262
  • Fax: 970-345-2265
Mailing address:
  • Phone: 970-345-2262
  • Fax: 970-345-2265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. JESSICA FILLA
Title or Position: BUSINESS MANAGER
Credential:
Phone: 970-345-2701