Southeast Colorado Hospital District Ambulance
Organization Active NPI Ambulance · Springfield, CO
NPI 1316167489 · NPPES record last updated Apr 29, 2024
Key facts
- NPI
- 1316167489
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- Legal business name
- SOUTHEAST COLORADO HOSPITAL DISTRICT AMBULANCE
- Practice address
- 972 Kansas St
Springfield, CO 81073-1643 - Phone
- (719) 523-4501
- Fax
- (719) 523-4290
- NPI assigned
- Apr 30, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- SOUTHEAST COLORADO HOSPITAL DISTRICT
Authorized official
- Name
- Carla Forrest
- Title
- Him Director
- Phone
- (719) 523-2125
Other NPIs on the same Medicare enrollment 2
Practitioners 15
-
Daniel Schaefer, MD
-
Derek Silver, PA-C
-
Mark J Vonderharr, PA-C
-
Roger W. Narvaez, M.D.
-
Ty Shettron, FNP
-
Mani Bashyam, M.D.
-
Nagesh Chopra, M.D.
-
Jeffrey Paul Johnson, APN, FNP
-
Roger Guy Allen Lever, M.D.
-
Judit Marton, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040310001440 | CO | Part B Supplier - Clinic/Group Practice | 6204725138 |
Receives reassigned benefits from 13 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Springfield, CO |
National Provider Directory
- Part of
- SE Colorado Hospital
Locations
200 E 10th Ave
Springfield, CO 81073
Phone (719) 523-4501
972 Kansas St
Springfield, CO 81073
Phone (719) 523-4501
204 E 10th Ave
Springfield, CO 81073
Phone (719) 523-4501
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | Yes |
Addresses
Primary practice location
972 Kansas St
Springfield, CO 81073-1643
Mailing address
373 E 10TH Ave
Springfield, CO 81073-1622
Phone (719) 523-4501
Other providers in Springfield, CO
- Southeast Colorado Hospital District
- Southeast Colorado Hospital District
- Southeast Colorado Hospital District
- Southeast Colorado Hospital District
- Southeast Colorado Hospital District - Facility
- Southeast Colorado Hospital District Laboratory
- Southeast Mental Health Services
- Southeast Mental Health Services
- Springfield Clinic
- Springfield Family Dental, PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.