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General NPI Number Information
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NPI Number | 1487470977
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Entity Type | Organization
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Legal Business Name | SOUTH CENTRAL COLFAX COUNTY SPECIAL HOSPITAL DISTRICT
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Dates
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Enumeration Date | 11/29/2024
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Last Update Date | 11/29/2024
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Provider Practice Location Address
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Address Line | 10 FIVE SPRINGS RD.
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City | ANGEL FIRE
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State | NM
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Zip | 87710
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Country | US
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Telephone | 575-377-3301
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 133
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City | ANGEL FIRE
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State | NM
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Zip | 87710-0133
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Country | US
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Telephone | 575-377-3301
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Fax | 575-377-3204
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ASHLEY DEHERRERA
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Credential |
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Telephone | 575-483-3301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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