Organization
WEST CUSTER COUNTY HOSPITAL DIST.
Active
Other names
Custer County HCBS
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TOLOA PEARL RN (ADMINISTRATOR)
(719) 783-2380
Entity
Organization
Contact information
Practice address
740 EDWARDS ST, WESTCLIFFE, CO 81252-8588
(719) 783-2380
Mailing address
PO BOX 120, WESTCLIFFE, CO 81252-0120
(719) 783-2380
(719) 783-2377
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04141362
—
CO
Enumeration date
07/14/2005
Last updated
07/21/2022
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