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Organization
LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY
Active
Organization
LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY
Active
Other names
SLV Regional Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL W. JOHNSON C.E.O. (CHIEF EXECUTIVE OFFICER)
(719) 589-2511
Entity
Organization
Contact information
Practice address
19021 HIGHWAY 285, LA JARA, CO 81140
(719) 274-6000
(719) 587-1372
Mailing address
106 BLANCA AVE, ALAMOSA, CO 81101-2340
(719) 589-3000
(719) 587-1372
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
68085770
—
CO
Enumeration date
02/06/2008
Last updated
02/06/2008
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