Healthcare Provider Details

I. General information

NPI: 1285722298
Provider Name (Legal Business Name): WALSH HOSPITAL DISTRICT HEALTHCARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 12/19/2024
Certification Date: 12/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 N NEVADA ST
WALSH CO
81090
US

IV. Provider business mailing address

PO BOX 206
WALSH CO
81090-0206
US

V. Phone/Fax

Practice location:
  • Phone: 719-324-5262
  • Fax: 719-324-5266
Mailing address:
  • Phone: 719-324-5262
  • Fax: 719-324-5266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1002
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MRS. RITA HETRICK
Title or Position: ADMINISTRATOR
Credential:
Phone: 719-324-5262