Healthcare Provider Details

I. General information

NPI: 1679058184
Provider Name (Legal Business Name): SOUTHWEST HEALTH SYSTEM, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2018
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 N MILDRED RD
CORTEZ CO
81321-2231
US

IV. Provider business mailing address

1311 N MILDRED RD
CORTEZ CO
81321-2231
US

V. Phone/Fax

Practice location:
  • Phone: 970-564-2091
  • Fax: 970-564-2670
Mailing address:
  • Phone: 970-564-2091
  • Fax: 970-564-2670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

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