Provider Demographics
NPI:1730185323
Name:YUMA DISTRICT HOSPITAL
Entity type:Organization
Organization Name:YUMA DISTRICT HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:SAXTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-848-5405
Mailing Address - Street 1:82 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:CO
Mailing Address - Zip Code:80720-1440
Mailing Address - Country:US
Mailing Address - Phone:970-345-6336
Mailing Address - Fax:
Practice Address - Street 1:82 MAIN AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:CO
Practice Address - Zip Code:80720-1440
Practice Address - Country:US
Practice Address - Phone:970-345-6336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YUMA DISTRICT HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-28
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO261QP2300X, 261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO17256879Medicaid
CODA3115OtherMEDICARE RR
CODA3115OtherMEDICARE RR
COC500648Medicare PIN