Provider Demographics
NPI:1801296645
Name:DELTA COUNTY HEALTH DEPT
Entity type:Organization
Organization Name:DELTA COUNTY HEALTH DEPT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:H
Authorized Official - Last Name:KOEHLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-874-2165
Mailing Address - Street 1:255 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:DELTA
Mailing Address - State:CO
Mailing Address - Zip Code:81416-1626
Mailing Address - Country:US
Mailing Address - Phone:970-874-2165
Mailing Address - Fax:970-874-2175
Practice Address - Street 1:255 W 6TH ST
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416-1626
Practice Address - Country:US
Practice Address - Phone:970-874-2165
Practice Address - Fax:970-874-2175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-29
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.0106312163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CORN.0106312OtherSTATE OF COLORADO NURSING LICENSE