Provider Demographics
NPI:1528583291
Name:COUNTY OF CUSTER
Entity Type:Organization
Organization Name:COUNTY OF CUSTER
Other - Org Name:CUSTER COUNTY PUBLIC HEALTH AGENCY
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELISA
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:MAGNUSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:719-783-3369
Mailing Address - Street 1:704 EDWARDS AVE
Mailing Address - Street 2:
Mailing Address - City:WESTCLIFFE
Mailing Address - State:CO
Mailing Address - Zip Code:81252-8588
Mailing Address - Country:US
Mailing Address - Phone:719-783-3369
Mailing Address - Fax:719-783-0959
Practice Address - Street 1:704 EDWARDS AVE
Practice Address - Street 2:
Practice Address - City:WESTCLIFFE
Practice Address - State:CO
Practice Address - Zip Code:81252-8588
Practice Address - Country:US
Practice Address - Phone:719-783-3369
Practice Address - Fax:719-783-0959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251K00000XAgenciesPublic Health or WelfareGroup - Single Specialty