Provider Demographics
NPI:1285612614
Name:SAGUACHE COUNTY PUBLIC HEALTH
Entity type:Organization
Organization Name:SAGUACHE COUNTY PUBLIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWSOM
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:719-655-2533
Mailing Address - Street 1:405 DENVER
Mailing Address - Street 2:PO BOX 68
Mailing Address - City:SAGUACHE
Mailing Address - State:CO
Mailing Address - Zip Code:81149
Mailing Address - Country:US
Mailing Address - Phone:719-655-2533
Mailing Address - Fax:719-655-0105
Practice Address - Street 1:405 DENVER
Practice Address - Street 2:
Practice Address - City:SAGUACHE
Practice Address - State:CO
Practice Address - Zip Code:81149
Practice Address - Country:US
Practice Address - Phone:719-655-2533
Practice Address - Fax:719-655-0105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO162872251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare