Healthcare Provider Details

I. General information

NPI: 1740295591
Provider Name (Legal Business Name): SEDGWICK COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 09/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 CEDAR ST
JULESBURG CO
80737-1121
US

IV. Provider business mailing address

900 CEDAR ST
JULESBURG CO
80737-1121
US

V. Phone/Fax

Practice location:
  • Phone: 970-474-3323
  • Fax: 970-474-2758
Mailing address:
  • Phone: 970-474-3323
  • Fax: 970-474-2758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number010170
License Number StateCO

VIII. Authorized Official

Name: DAVID GARNAS
Title or Position: CEO
Credential:
Phone: 970-474-3323