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General NPI Number Information
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NPI Number | 1245238955
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Entity Type | Organization
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Legal Business Name | WEST CUSTER COUNTY HOSPITAL DIST
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 05/13/2022
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Provider Practice Location Address
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Address Line | 701 EDWARDS AVENUE
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City | WESTCLIFFE
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State | CO
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Zip | 81252-8588
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Country | US
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Telephone | 719-783-4447
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Fax | 719-783-2086
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Provider Business Mailing Address
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Address Line | 704 EDWARDS
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City | WESTCLIFFE
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State | CO
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Zip | 81252
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Country | US
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Telephone | 719-783-2380
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Fax | 719-783-2377
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Authorized Official
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Title or Position | EMS MANAGER
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Name | TYLER HARKINS
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Credential |
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Telephone | 615-693-0251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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