Healthcare Provider Details

I. General information

NPI: 1669747093
Provider Name (Legal Business Name): ARKANSAS VALLEY REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2012
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 CARSON AVE
LA JUNTA CO
81050-2751
US

IV. Provider business mailing address

1100 CARSON AVE
LA JUNTA CO
81050-2751
US

V. Phone/Fax

Practice location:
  • Phone: 719-384-5412
  • Fax: 719-383-6005
Mailing address:
  • Phone: 719-384-5412
  • Fax: 719-383-6005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: HEIDI J GEARHART
Title or Position: CNO
Credential: MSN, RN
Phone: 719-384-5412