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Organization
LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY
Active
Organization
LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY
Active
Parent organization
SLV REGIONAL MEDICAL CENTER
Other names
SLV Regional Medical Center Physician Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
SLV REGIONAL MEDICAL CENTER
Authorized official
MR. RUSSELL W JOHNSON CEO (CHIEF EXECUTIVE OFFICER)
(719) 587-1200
Entity
Organization
Contact information
Practice address
103 CHICO CT, SUITE B, MONTE VISTA, CO 81144-1065
(719) 852-7240
(719) 852-0332
Mailing address
106 BLANCA AVE, ALAMOSA, CO 81101-2340
(719) 589-2511
(719) 587-1372
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
NULL
111N00000X
Chiropractor
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
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
04/01/2009
Last updated
04/01/2009
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