Organization
CONEJOS COUNTY HOSPITAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS NEWTON HENTON (ADMINISTRATOR)
(719) 274-6004
Entity
Organization
Contact information
Practice address
509 MAIN STREET, LA JARA, CO 81140
(719) 274-5000
(719) 274-4111
Mailing address
509 MAIN STREET, LA JARA, CO 81140
(719) 274-5000
(719) 274-4111
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40926834
—
CO
Enumeration date
03/31/2006
Last updated
02/17/2009
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