Organization Name: | SAN JUAN COUNTY PUBLIC HEALTH SERVICE |
NPI Number: | 1194975383 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TERRI A BROKERING (DIRECTOR) |
Mailing Address: | 1315 Snowden Street Silverton |
State: | CO US |
Postal Code: | 81433 |
Phone Number: | 9703870242 |
Fax Number: | 9703875036 |
NPI Enumeration Date: | 09/24/2008 |
NPI Last Update Date: | 06/14/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251K00000X |
License Number: | 58259 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Public Health or Welfare |
Taxonomy Specialization: | |
Taxonomy Definition: |