Provider Demographics
NPI:1215197504
Name:LARIMER CNTY HLTH DEPT FP
Entity Type:Organization
Organization Name:LARIMER CNTY HLTH DEPT FP
Other - Org Name:LARIMER COUNTY DEPT OF HEALTH AND ENVIR
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ACCOUNTING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHILD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-498-6712
Mailing Address - Street 1:1525 BLUE SPRUCE DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-2004
Mailing Address - Country:US
Mailing Address - Phone:970-498-6712
Mailing Address - Fax:
Practice Address - Street 1:1525 BLUE SPRUCE DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-2004
Practice Address - Country:US
Practice Address - Phone:970-498-6712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04000758Medicaid