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General NPI Number Information
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NPI Number | 1457315152
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Entity Type | Organization
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Legal Business Name | ST. VINCENT GENERAL HOSPITAL DISTRICT
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Dates
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Enumeration Date | 04/12/2006
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Last Update Date | 08/27/2024
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Provider Practice Location Address
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Address Line | 816 W 4TH ST
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City | LEADVILLE
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State | CO
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Zip | 80461-3861
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Country | US
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Telephone | 719-486-0230
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Fax | 719-486-1077
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Provider Business Mailing Address
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Address Line | 822 W 4TH ST
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City | LEADVILLE
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State | CO
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Zip | 80461
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Country | US
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Telephone | 719-486-0230
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Fax | 719-486-1077
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | ANDREW DREESEN
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Credential |
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Telephone | 719-486-7161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 0185
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License Number State | CO
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 010908
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License Number State | CO
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