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General NPI Number Information
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NPI Number | 1356901649
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Entity Type | Organization
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Legal Business Name | PARK HOSPITAL DISTRICT
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Dates
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Enumeration Date | 06/18/2019
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Last Update Date | 11/01/2021
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Provider Practice Location Address
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Address Line | 555 PROSPECT AVE
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City | ESTES PARK
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State | CO
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Zip | 80517-6312
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Country | US
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Telephone | 970-586-2317
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Fax |
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Provider Business Mailing Address
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Address Line | 555 PROSPECT AVE
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City | ESTES PARK
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State | CO
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Zip | 80517-6312
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALER
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Name | JACKIE DAVIES
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Credential |
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Telephone | 970-577-4490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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