Provider Demographics
NPI:1376754259
Name:COUNTY OF EAGLE
Entity Type:Organization
Organization Name:COUNTY OF EAGLE
Other - Org Name:EAGLE COUNTY HEALTH & HUMAN SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PUBLIC HEALTH MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNSAKER
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:970-328-8819
Mailing Address - Street 1:551 BROADWAY
Mailing Address - Street 2:PO BOX 660
Mailing Address - City:EAGLE
Mailing Address - State:CO
Mailing Address - Zip Code:81631-0660
Mailing Address - Country:US
Mailing Address - Phone:970-328-8840
Mailing Address - Fax:970-328-8829
Practice Address - Street 1:551 BROADWAY
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:CO
Practice Address - Zip Code:81631-0660
Practice Address - Country:US
Practice Address - Phone:970-328-8840
Practice Address - Fax:970-328-8829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2008-08-15
Deactivation Date:2008-06-03
Deactivation Code:
Reactivation Date:2008-08-15
Provider Licenses
StateLicense IDTaxonomies
CO251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO004445094Medicaid