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NPI Code Detail

MEDICARE: LAS ANIMAS-HUERFANO COUNTIES DISTRICT HEALTH DEPARTMENT

MEDICARE: LAS ANIMAS-HUERFANO COUNTIES DISTRICT HEALTH DEPARTMENT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251K00000XPublic Health or Welfare Agency0268CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760540900
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAS ANIMAS-HUERFANO COUNTIES DISTRICT HEALTH DEPARTMENT
Provider Business Mailing Address
First Line : 412 BENEDICTA AVE
Second Line :
City : TRINIDAD
State : CO
Zip : 81082-2005
Country : US
Telephone Number : 719-846-2213
Fax Number : 719-846-4472
Provider Business Practice Location Address
First Line : 412 BENEDICTA AVE
Second Line :
City : TRINIDAD
State : CO
Zip : 81082-2005
Country : US
Telephone Number : 719-846-2213
Fax Number : 719-846-4472
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MS. KIMBERLY GONZALES
Credential :
Telephone Number : 719-846-2213
Provider Enumeration Date : 12/04/2006
Last Update Date : 09/30/2024

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Directions to “LAS ANIMAS-HUERFANO COUNTIES DISTRICT HEALTH DEPARTMENT ” Practice Location

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