Healthcare Provider Details

I. General information

NPI: 1619986684
Provider Name (Legal Business Name): HUERFANO COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 07/25/2022
Certification Date: 07/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23500 US HIGHWAY 160
WALSENBURG CO
81089-9524
US

IV. Provider business mailing address

23500 US HIGHWAY 160
WALSENBURG CO
81089-9524
US

V. Phone/Fax

Practice location:
  • Phone: 800-645-8387
  • Fax:
Mailing address:
  • Phone: 719-738-5144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number0207YZ
License Number StateCO

VIII. Authorized Official

Name: COLETTE MARTIN
Title or Position: CFO
Credential:
Phone: 719-738-5137