Provider Demographics
NPI:1639173180
Name:COUNTY OF ALAMOSA
Entity Type:Organization
Organization Name:COUNTY OF ALAMOSA
Other - Org Name:ALAMOSA COUNTY PUBLIC HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GEISER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-589-6639
Mailing Address - Street 1:8900 INDEPENDENCE WAY
Mailing Address - Street 2:BUILDING B
Mailing Address - City:ALAMOSA
Mailing Address - State:CO
Mailing Address - Zip Code:81101-9412
Mailing Address - Country:US
Mailing Address - Phone:719-589-6639
Mailing Address - Fax:719-589-1103
Practice Address - Street 1:8900 INDEPENDENCE WAY
Practice Address - Street 2:BUILDING B
Practice Address - City:ALAMOSA
Practice Address - State:CO
Practice Address - Zip Code:81101-9412
Practice Address - Country:US
Practice Address - Phone:719-589-6639
Practice Address - Fax:719-589-1103
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALAMOSA COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-10
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO05726005251E00000X
CO067026251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05726005Medicaid
CO=========OtherOTHER INSURANCE HOME HEAL
CO=========OtherOTHER INSURANCE HOME HEAL