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General NPI Number Information
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NPI Number | 1184406159
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Entity Type | Organization
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Legal Business Name | COUNTY OF ARCHULETA
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Dates
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Enumeration Date | 10/16/2023
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | 502 S 8TH ST
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City | PAGOSA SPRINGS
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State | CO
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Zip | 81147
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Country | US
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Telephone | 970-264-8440
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1507
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City | PAGOSA SPRINGS
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State | CO
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Zip | 81147-1481
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Country | US
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Telephone | 970-264-8440
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF PUBLIC HEALTH
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Name | ASHLEY WILSON
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Credential | MPH
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Telephone | 970-264-8440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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License Number |
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License Number State |
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