Provider Demographics
NPI:1750592622
Name:EAGLE COUNTY HEALTH & HUMAN SERVICE
Entity type:Organization
Organization Name:EAGLE COUNTY HEALTH & HUMAN SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGGIORE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:970-328-8822
Mailing Address - Street 1:551 BROADWAY
Mailing Address - Street 2:PO BOX 660
Mailing Address - City:EAGLE
Mailing Address - State:CO
Mailing Address - Zip Code:81631-0660
Mailing Address - Country:US
Mailing Address - Phone:970-328-8840
Mailing Address - Fax:970-328-8829
Practice Address - Street 1:551 BROADWAY
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:CO
Practice Address - Zip Code:81631-0660
Practice Address - Country:US
Practice Address - Phone:970-328-8822
Practice Address - Fax:970-328-8829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO40789251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC71026Medicare PIN