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General NPI Number Information
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NPI Number | 1366593196
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Entity Type | Organization
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Legal Business Name | FREMONT COUNTY
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 172 JUSTICE CENTER RD
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City | CANON CITY
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State | CO
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Zip | 81212-9354
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Country | US
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Telephone | 719-275-2318
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Fax | 719-275-5206
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Provider Business Mailing Address
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Address Line | 172 JUSTICE CENTER RD
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City | CANON CITY
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State | CO
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Zip | 81212-9354
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Country | US
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Telephone | 719-275-2318
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Fax | 719-275-5206
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. STEVEN A CLIFTON
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Credential |
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Telephone | 719-275-2318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 09000225
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 06200224
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License Number State | CO
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