Healthcare Provider Details

I. General information

NPI: 1932475894
Provider Name (Legal Business Name): SOUTHWEST HEALTH SYSTEM, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2012
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 N MILDRED ROAD
CORTEZ CO
81321-2231
US

IV. Provider business mailing address

1311 N MILDRED ROAD
CORTEZ CO
81321-2231
US

V. Phone/Fax

Practice location:
  • Phone: 970-565-0712
  • Fax: 970-565-0732
Mailing address:
  • Phone: 970-564-2152
  • Fax: 970-564-2155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH THEINE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 970-564-2146