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General NPI Number Information
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NPI Number | 1235954280
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Entity Type | Organization
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Legal Business Name | UPPER SAN JUAN HEALTH SERVICE DISTRICT
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Dates
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Enumeration Date | 11/15/2024
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Last Update Date | 11/15/2024
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Provider Practice Location Address
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Address Line | 75 S PAGOSA BLVD
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City | PAGOSA SPRINGS
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State | CO
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Zip | 81147-7910
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Country | US
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Telephone | 970-731-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 95 S PAGOSA BLVD
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City | PAGOSA SPRINGS
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State | CO
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Zip | 81147-8329
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Country | US
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Telephone | 970-731-3700
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | RHONDA PERRITT WEBB
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Credential | MD
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Telephone | 970-731-3700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC0050X
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Taxonomy Name | Critical Access Hospital Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number |
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License Number State |
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