Provider Demographics
NPI:1275536146
Name:MESA COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:MESA COUNTY HEALTH DEPARTMENT
Other - Org Name:NONE
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:KUHR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-248-6974
Mailing Address - Street 1:P.O. BOX 20000
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81502-5033
Mailing Address - Country:US
Mailing Address - Phone:970-248-6974
Mailing Address - Fax:970-248-6974
Practice Address - Street 1:510 29 1/2 ROAD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81504
Practice Address - Country:US
Practice Address - Phone:970-248-6905
Practice Address - Fax:970-248-6977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO39245163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04420097Medicaid
CO04006128Medicaid
CO233308Medicare PIN