Healthcare Provider Details

I. General information

NPI: 1003213596
Provider Name (Legal Business Name): SAN JUAN COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2014
Last Update Date: 10/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 SNOWDEN ST.
SILVERTON CO
81433
US

IV. Provider business mailing address

PO BOX 619
SILVERTON CO
81433-0619
US

V. Phone/Fax

Practice location:
  • Phone: 970-387-0242
  • Fax: 970-387-5036
Mailing address:
  • Phone: 970-387-0242
  • Fax: 970-387-5036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number25978
License Number StateCO

VIII. Authorized Official

Name: REBECCA B JOYCE
Title or Position: DIRECTOR
Credential:
Phone: 970-387-0242