Provider Demographics
NPI:1124254545
Name:SOUTH CENTRAL COLFAX COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:SOUTH CENTRAL COLFAX COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNABELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SILLAS-GRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-377-3301
Mailing Address - Street 1:31039B HWY 64
Mailing Address - Street 2:
Mailing Address - City:CIMARRON
Mailing Address - State:NM
Mailing Address - Zip Code:87714-9646
Mailing Address - Country:US
Mailing Address - Phone:575-377-3301
Mailing Address - Fax:575-376-2107
Practice Address - Street 1:31039B HWY 64
Practice Address - Street 2:
Practice Address - City:CIMARRON
Practice Address - State:NM
Practice Address - Zip Code:87714-9646
Practice Address - Country:US
Practice Address - Phone:575-377-3301
Practice Address - Fax:575-376-2107
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTH CENTRAL COLFAX COUNTY HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-01
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service