Provider Demographics
NPI:1750535266
Name:WEST CUSTER COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:WEST CUSTER COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:NIMNICHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-783-2380
Mailing Address - Street 1:PO BOX 120
Mailing Address - Street 2:
Mailing Address - City:WESTCLIFFE
Mailing Address - State:CO
Mailing Address - Zip Code:81252
Mailing Address - Country:US
Mailing Address - Phone:719-783-2380
Mailing Address - Fax:719-783-2377
Practice Address - Street 1:740 EDWARDS ST.
Practice Address - Street 2:
Practice Address - City:WESTCLIFFE
Practice Address - State:CO
Practice Address - Zip Code:81252-8588
Practice Address - Country:US
Practice Address - Phone:719-783-2380
Practice Address - Fax:719-783-2377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-11
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site