1326464280 NPI number — RIO BLANCO COUNTY

Table of content: (NPI 1326464280)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326464280 NPI number — RIO BLANCO COUNTY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RIO BLANCO COUNTY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326464280
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/14/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
345 E MARKET ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MEEKER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81641-9658
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-878-9525
Provider Business Mailing Address Fax Number:
970-975-2233

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
345 E MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEEKER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81641-9658
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-878-9525
Provider Business Practice Location Address Fax Number:
970-975-2233
Provider Enumeration Date:
03/14/2014

Additional Information

Authorized Official

Authorized Official Last Name:
ZUFELT
Authorized Official First Name:
COLLEEN
Authorized Official Middle Name:
MICHELLE
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
970-878-9525

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X , with the licence number:  RN.0122775 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 04462099 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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