Provider Demographics
NPI:1225601461
Name:GARFIELD COUNTY PUBLIC HEALTH
Entity Type:Organization
Organization Name:GARFIELD COUNTY PUBLIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:LANCASTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-945-6614
Mailing Address - Street 1:2014 BLAKE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601-4229
Mailing Address - Country:US
Mailing Address - Phone:970-945-6614
Mailing Address - Fax:970-947-0155
Practice Address - Street 1:2014 BLAKE AVE
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-4229
Practice Address - Country:US
Practice Address - Phone:970-945-6614
Practice Address - Fax:970-947-0155
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GARFIELD COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-23
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000146822Medicaid