Provider Demographics
NPI:1649982257
Name:SALIDA HOSPITAL DISTRICT
Entity type:Organization
Organization Name:SALIDA HOSPITAL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FAGERBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-530-2213
Mailing Address - Street 1:PO BOX 492
Mailing Address - Street 2:
Mailing Address - City:SALIDA
Mailing Address - State:CO
Mailing Address - Zip Code:81201-0492
Mailing Address - Country:US
Mailing Address - Phone:719-836-0334
Mailing Address - Fax:
Practice Address - Street 1:525 HATHAWAY STREET
Practice Address - Street 2:
Practice Address - City:FAIRPLAY
Practice Address - State:CO
Practice Address - Zip Code:80440
Practice Address - Country:US
Practice Address - Phone:719-836-0334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care