| Lutheran Hospital Association Of The San Luis Valley | |
|
115 Main Street Antonito CO 81120-0087 | |
| (719) 376-2308 | |
| (719) 376-2395 |
| Full Name | Lutheran Hospital Association Of The San Luis Valley |
|---|---|
| Speciality | Clinic/Center |
| Location | 115 Main Street, Antonito, Colorado |
| Authorized Official Name and Position | Konnie L. Martin (CCH CEO) |
| Authorized Official Contact | 7195871206 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lutheran Hospital Association Of The San Luis Valley 19021 Us Highway 285 La Jara CO 81140 Ph: (719) 274-5121 | Lutheran Hospital Association Of The San Luis Valley 115 Main Street Antonito CO 81120-0087 Ph: (719) 376-2308 |
| NPI Number | 1821057860 |
|---|---|
| Provider Enumeration Date | 03/20/2006 |
| Last Update Date | 11/24/2020 |
| Medicare PECOS PAC ID | 4789589094 |
|---|---|
| Medicare Enrollment ID | O20130805000712 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821057860 | NPI | - | NPPES |
| 93388560 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
San Luis Valley Community Mental Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9th & Dahlia, Aka 915 Dahlia, Antonito, CO 81120 Phone: 719-589-3671 | |
Valley-wide Health Systems, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10th And Dahlia, Antonito, CO 81120 Phone: 719-376-5426 Fax: 719-376-5880 | |
San Luis Valley Community Mental Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 915 Dahlia, Antonito, CO 81120 Phone: 719-589-3671 Fax: 719-587-6824 | |
San Luis Valley Community Mental Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9th & Dahlia, Aka 915 Dahlia, Antonito, CO 81120 Phone: 719-589-3671 | |
Conejos County Hospital Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 315 Main Street, Antonito, CO 81120 Phone: 719-376-2308 Fax: 719-376-2395 | |
Valley-wide Health Systems, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13099 County Rd G., Antonito, CO 81120 Phone: 719-376-7000 |