Healthcare Provider Details

I. General information

NPI: 1861442485
Provider Name (Legal Business Name): RIO BLANCO COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 11/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E MAIN ST
RANGELY CO
81648-2718
US

IV. Provider business mailing address

101 E MAIN ST
RANGELY CO
81648-2718
US

V. Phone/Fax

Practice location:
  • Phone: 970-878-9525
  • Fax: 970-675-2233
Mailing address:
  • Phone: 970-878-9525
  • Fax: 970-675-2233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number167938
License Number StateCO

VIII. Authorized Official

Name: JENNIFER O'HEARON
Title or Position: DIRECTOR FOR PUBLIC HEALTH
Credential:
Phone: 970-878-9525