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General NPI Number Information
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NPI Number | 1578689527
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Entity Type | Organization
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Legal Business Name | SOUTHWEST HEALTH SYSTEM, INC.
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 1311A N MILDRED RD
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City | CORTEZ
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State | CO
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Zip | 81321-2231
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Country | US
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Telephone | 970-565-8556
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Fax | 970-564-1134
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Provider Business Mailing Address
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Address Line | 1311 N MILDRED RD
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City | CORTEZ
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State | CO
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Zip | 81321-2231
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Country | US
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Telephone | 970-564-2258
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Fax | 970-564-2155
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | JOSEPH THEINE
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Credential |
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Telephone | 970-564-2146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 0179
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License Number State | CO
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