# CONEJOS COUNTY HOSPITAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376504092
- **Authorized official:** MR. THOMAS NEWTON HENTON (ADMINISTRATOR)
- **Authorized official phone:** (719) 274-6004

## Contact information

- **Practice address:** 509 MAIN STREET, LA JARA, CO 81140
- **Practice address phone:** (719) 274-5000
- **Practice address fax:** (719) 274-4111
- **Mailing address:** 509 MAIN STREET, LA JARA, CO 81140
- **Mailing address phone:** (719) 274-5000
- **Mailing address fax:** (719) 274-4111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/31/2006
- **Last updated:** 02/17/2009