Healthcare Provider Details

I. General information

NPI: 1124650221
Provider Name (Legal Business Name): TRI-COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2020
Last Update Date: 02/06/2020
Certification Date: 02/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 S 20TH AVE STE FG
BRIGHTON CO
80601-3705
US

IV. Provider business mailing address

6162 S WILLOW DR STE 100
GREENWOOD VILLAGE CO
80111-5113
US

V. Phone/Fax

Practice location:
  • Phone: 303-659-2335
  • Fax: 303-741-4173
Mailing address:
  • Phone: 303-220-9200
  • Fax: 303-741-4173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER LUDWIG
Title or Position: DEPUTY DIRECTOR
Credential:
Phone: 303-220-9200