Provider Demographics
NPI:1073707279
Name:COUNTY OF OURAY
Entity Type:Organization
Organization Name:COUNTY OF OURAY
Other - Org Name:OURAY COUNTY PUBLIC HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PUBLIC HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELISABETH
Authorized Official - Middle Name:WALTRAUD
Authorized Official - Last Name:LAWACZECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-325-4670
Mailing Address - Street 1:PO BOX 670
Mailing Address - Street 2:
Mailing Address - City:OURAY
Mailing Address - State:CO
Mailing Address - Zip Code:81427-0670
Mailing Address - Country:US
Mailing Address - Phone:970-325-4670
Mailing Address - Fax:970-325-7314
Practice Address - Street 1:302 2ND STREET
Practice Address - Street 2:
Practice Address - City:OURAY
Practice Address - State:CO
Practice Address - Zip Code:81427-0670
Practice Address - Country:US
Practice Address - Phone:970-325-4670
Practice Address - Fax:970-325-7314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO41501080Medicaid
P01278032OtherRAILROAD WORKERS MEDICARE PTAN
P01278032OtherRAILROAD WORKERS MEDICARE PTAN