Healthcare Provider Details

I. General information

NPI: 1134185903
Provider Name (Legal Business Name): HAXTUN HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 07/22/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 S COLORADO AVE
HAXTUN CO
80731-5011
US

IV. Provider business mailing address

235 W FLETCHER
HAXTUN CO
80731-2737
US

V. Phone/Fax

Practice location:
  • Phone: 970-774-6187
  • Fax: 970-774-7374
Mailing address:
  • Phone: 970-774-6123
  • Fax: 970-774-6158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: HEIDI CARPENTER
Title or Position: CLINIC SERVICES MANAGER
Credential:
Phone: 970-774-6123