Healthcare Provider Details

I. General information

NPI: 1215065099
Provider Name (Legal Business Name): CUSTER COUNTY SCHOOL DISTRICT 1
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 MAIN ST
WESTCLIFFE CO
81252
US

IV. Provider business mailing address

PO BOX 730
WESTCLIFFE CO
81252-0730
US

V. Phone/Fax

Practice location:
  • Phone: 719-783-2357
  • Fax:
Mailing address:
  • Phone: 719-783-2357
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateCO

VIII. Authorized Official

Name: GAIL STOFTZFUS
Title or Position: DISTRICT NURSE
Credential: R.N.
Phone: 719-783-2357