Provider Demographics
NPI:1861442485
Name:RIO BLANCO COUNTY
Entity Type:Organization
Organization Name:RIO BLANCO COUNTY
Other - Org Name:RIO BLANCO NURSING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR FOR PUBLIC HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:O'HEARON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-878-9525
Mailing Address - Street 1:101 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RANGELY
Mailing Address - State:CO
Mailing Address - Zip Code:81648-2718
Mailing Address - Country:US
Mailing Address - Phone:970-878-9525
Mailing Address - Fax:970-675-2233
Practice Address - Street 1:101 E MAIN ST
Practice Address - Street 2:
Practice Address - City:RANGELY
Practice Address - State:CO
Practice Address - Zip Code:81648-2718
Practice Address - Country:US
Practice Address - Phone:970-878-9525
Practice Address - Fax:970-675-2233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO167938251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO86-6000-798OtherTAX #
CO86-6000-798OtherTAX #
CO86-6000-798OtherTAX #