Provider Demographics
NPI:1558607721
Name:GARFIELD COUNTY
Entity Type:Organization
Organization Name:GARFIELD COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-625-5200
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 STREET
Practice Address - Street 2:
Practice Address - City:RIFLE
Practice Address - State:CO
Practice Address - Zip Code:81650
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:2012-12-17
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO55105050Medicaid