Provider Demographics
NPI:1720086333
Name:YUMA DISTRICT HOSPITAL
Entity Type:Organization
Organization Name:YUMA DISTRICT HOSPITAL
Other - Org Name:YUMA DISTRICT HOSPITAL HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:SAXTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-848-5405
Mailing Address - Street 1:1000 W 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:CO
Mailing Address - Zip Code:80759-2641
Mailing Address - Country:US
Mailing Address - Phone:970-848-4758
Mailing Address - Fax:
Practice Address - Street 1:1000 W 8TH AVE
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:CO
Practice Address - Zip Code:80759-2641
Practice Address - Country:US
Practice Address - Phone:970-848-4758
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YUMA DISTRICT HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-08
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO040172251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05700430Medicaid
CO05700430Medicaid