Organization
COUNTY COMMISSIONERS OF BACA
Active
Parent organization
BACA COUNTY PUBLIC HEALTH AGENCY
Organization subpart
Yes
Provider details
NPI number
Legal business name
BACA COUNTY PUBLIC HEALTH AGENCY
Authorized official
MS. ROBIN TRUJILLO RN (AGENCY DIRECTOR)
(719) 523-6621
Entity
Organization
Contact information
Practice address
741 MAIN ST, SUITE #4, SPRINGFIELD, CO 81073-1548
(719) 523-6621
(719) 523-6537
Mailing address
741 MAIN ST, SUITE #4, SPRINGFIELD, CO 81073-1548
(719) 523-6621
(719) 523-6537
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
172848
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04102
MEDICARE PAYER I.D.
CO
05
—
04468096
—
CO
05
—
CO04953
—
CO
Enumeration date
10/21/2008
Last updated
10/11/2011
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