Healthcare Provider Details

I. General information

NPI: 1336721265
Provider Name (Legal Business Name): SOUTHEAST COLORADO HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2021
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

972 KANSAS ST
SPRINGFIELD CO
81073-1643
US

IV. Provider business mailing address

373 E 10TH AVE
SPRINGFIELD CO
81073-1622
US

V. Phone/Fax

Practice location:
  • Phone: 719-523-4501
  • Fax:
Mailing address:
  • Phone: 719-523-4501
  • Fax: 719-523-4290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: CARLA FORREST
Title or Position: HIM DIRECTOR
Credential:
Phone: 719-523-2125