# LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SLV REGIONAL MEDICAL CENTER
- **Other names:** SLV Regional Medical Center Physician Services
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1184866410
- **Legal business name:** SLV REGIONAL MEDICAL CENTER
- **Authorized official:** MR. RUSSELL W JOHNSON CEO (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (719) 587-1200

## Contact information

- **Practice address:** 103 CHICO CT, SUITE B, MONTE VISTA, CO 81144-1065
- **Practice address phone:** (719) 852-7240
- **Practice address fax:** (719) 852-0332
- **Mailing address:** 106 BLANCA AVE, ALAMOSA, CO 81101-2340
- **Mailing address phone:** (719) 589-2511
- **Mailing address fax:** (719) 587-1372

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 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

- **Enumeration date:** 04/01/2009
- **Last updated:** 04/01/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 68085770 | — | CO |