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Organization
SOUTHEAST COLORADO HOSPITAL DISTRICT
Active
Organization
SOUTHEAST COLORADO HOSPITAL DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA FORREST (HIM DIRECTOR)
(719) 523-2125
Entity
Organization
Contact information
Practice address
373 E 10TH AVE, SPRINGFIELD, CO 81073-1622
(719) 523-4501
(719) 523-4290
Mailing address
373 E 10TH AVE, SPRINGFIELD, CO 81073-1622
(719) 523-4501
(719) 523-4290
Taxonomy
Speciality
Code
Description
License number
State
261QC0050X
Critical Access Hospital Clinic/Center
—
CO
275N00000X
Medicare Defined Swing Bed Hospital Unit
—
CO
282NC0060X
Critical Access Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010221
COLORADO LICENSE NUMBER
CO
05
—
05085006
—
CO
01
—
06Z311
MEDICARE SKILLED
CO
Enumeration date
10/02/2006
Last updated
04/21/2021
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