NPIMap

Organization Active NPI

Walsh Hospital District Healthcare Center

Doing business as Walsh Ambulance Service

  • Land Ambulance
  • Walsh, CO
National Provider Identifier
1285722298
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
1002 Issued in CO
Legal business name
WALSH HOSPITAL DISTRICT HEALTHCARE CENTER
Doing business as
Walsh Ambulance Service
Practice address
150 N Nevada St
Walsh, CO 81090
Phone
(719) 324-5262
Fax
(719) 324-5266
NPI assigned
Oct 11, 2006
Last updated
Dec 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Rita Hetrick
Title
Administrator
Phone
(719) 324-5262

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 1002 CO Primary
Non-emergency Medical Transport (VAN) 343900000X

Addresses

Primary practice location

150 N Nevada St
Walsh, CO 81090

Mailing address

PO Box 206
Walsh, CO 81090-0206
Phone (719) 324-5262

Other identifiers 2

IdentifierTypeStateIssuer
06060230MedicaidCO
603448OtherCOAMBULANCE-BLUE CROSS

Other names 1

  • WALSH AMBULANCE SERVICE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100226000486 CO Part B Supplier - Ambulance Service Supplier 4789576463 Practice locations: Walsh, CO

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Walsh Healthcare Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Walsh Medical ClinicWalsh, CO, CCN 063874 Rural health clinic Operational/Managerial Control (100%) Apr 1, 2009

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734566400000",
    "number": "1285722298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 206",
            "city": "WALSH",
            "state": "CO",
            "postal_code": "810900206",
            "telephone_number": "719-324-5262",
            "fax_number": "719-324-5266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N NEVADA ST",
            "city": "WALSH",
            "state": "CO",
            "postal_code": "81090",
            "telephone_number": "719-324-5262",
            "fax_number": "719-324-5266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALSH HOSPITAL DISTRICT HEALTHCARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A",
        "authorized_official_last_name": "HETRICK",
        "authorized_official_first_name": "RITA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "719-324-5262",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "CO",
            "license": "1002",
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06060230",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMBULANCE-BLUE CROSS",
            "identifier": "603448",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WALSH AMBULANCE SERVICE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WALSH AMBULANCE SERVICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Walsh, CO

Sources for this page

Verify at the official NPI Registry.