| Lutheran Hospital Association Of The San Luis Valley | |
|
509 Main Street La Jara CO 81140 | |
| (719) 274-5000 | |
| (719) 274-4111 |
| Full Name | Lutheran Hospital Association Of The San Luis Valley |
|---|---|
| Speciality | Clinic/Center |
| Location | 509 Main Street, La Jara, Colorado |
| Authorized Official Name and Position | Henry Garvin (CCH CEO) |
| Authorized Official Contact | 7192746004 |
| 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 81140-9410 Ph: (719) 274-5000 | Lutheran Hospital Association Of The San Luis Valley 509 Main Street La Jara CO 81140 Ph: (719) 274-5000 |
| NPI Number | 1942511019 |
|---|---|
| Provider Enumeration Date | 06/23/2010 |
| Last Update Date | 08/06/2013 |
| Medicare PECOS PAC ID | 4789589094 |
|---|---|
| Medicare Enrollment ID | O20130812000167 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942511019 | NPI | - | NPPES |
| 55601359 | Medicaid | CO | |
| 1376504092 | Other | CO | PREVIOUS NPI NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 011020 (Colorado) | Primary |
San Luis Valley Community Mental Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 322 Walnut Street, La Jara, CO 81140 Phone: 719-589-3671 | |
Conejos County Hospital Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 509 Main Street, La Jara, CO 81140 Phone: 719-274-5000 Fax: 719-274-4111 | |
San Luis Valley Community Mental Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 322 Walnut, La Jara, CO 81140 Phone: 719-589-3671 Fax: 719-587-6824 | |
C&g Health Care Management Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 39 Calle Miller, La Jara, CO 81140 Phone: 719-274-3311 |