Provider Demographics
NPI:1396852620
Name:GARFIELD COUNTY PUBLIC HEALTH
Entity Type:Organization
Organization Name:GARFIELD COUNTY PUBLIC HEALTH
Other - Org Name:GARFIELD COUNTY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MS
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 AVENUE
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601
Mailing Address - Country:US
Mailing Address - Phone:970-945-6614
Mailing Address - Fax:970-947-0155
Practice Address - Street 1:195 W 14TH
Practice Address - Street 2:
Practice Address - City:RIFLE
Practice Address - State:CO
Practice Address - Zip Code:81650-4716
Practice Address - Country:US
Practice Address - Phone:970-625-5200
Practice Address - Fax:970-625-4804
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GARFIELD COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-24
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251K00000XAgenciesPublic Health or Welfare
No124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04540290Medicaid
CO04540290Medicaid