Healthcare Provider Details

I. General information

NPI: 1992479513
Provider Name (Legal Business Name): COLORADO WEST HEALTHCARE SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2021
Last Update Date: 08/06/2021
Certification Date: 07/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2351 G RD
GRAND JUNCTION CO
81505-9641
US

IV. Provider business mailing address

PO BOX 1687
GRAND JUNCTION CO
81502-1687
US

V. Phone/Fax

Practice location:
  • Phone: 970-242-0920
  • Fax: 970-257-6251
Mailing address:
  • Phone: 970-242-0920
  • Fax: 970-257-6251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: CHRISTIAN THOMAS
Title or Position: CEO
Credential:
Phone: 970-644-3011