Provider Demographics
NPI:1548965999
Name:TRINIDAD AREA HEALTH ASSOCIATION
Entity type:Organization
Organization Name:TRINIDAD AREA HEALTH ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVARETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-846-9213
Mailing Address - Street 1:410 BENEDICTA AVE
Mailing Address - Street 2:
Mailing Address - City:TRINIDAD
Mailing Address - State:CO
Mailing Address - Zip Code:81082-2005
Mailing Address - Country:US
Mailing Address - Phone:719-846-9213
Mailing Address - Fax:719-845-4243
Practice Address - Street 1:328 S BONAVENTURE AVE
Practice Address - Street 2:
Practice Address - City:TRINIDAD
Practice Address - State:CO
Practice Address - Zip Code:81082-2086
Practice Address - Country:US
Practice Address - Phone:719-846-9213
Practice Address - Fax:719-845-4243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-04
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty