Healthcare Provider Details

I. General information

NPI: 1821052929
Provider Name (Legal Business Name): PROWERS COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 10/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 KENDALL DRIVE
LAMAR CO
81052-3942
US

IV. Provider business mailing address

401 KENDALL DRIVE
LAMAR CO
81052-3942
US

V. Phone/Fax

Practice location:
  • Phone: 719-336-4343
  • Fax: 719-336-7207
Mailing address:
  • Phone: 719-336-4343
  • Fax: 719-336-7207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number010217
License Number StateCO

VIII. Authorized Official

Name: KAREN L BRYANT
Title or Position: C.O.O.
Credential:
Phone: 719-336-5147