Active NPI
Southern Colorado Ute Service Unit
- Federal Public Health Clinic/Center
- Towaoc, CO
National Provider Identifier
1629344908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federal Public Health Clinic/Center
- Legal business name
- SOUTHERN COLORADO UTE SERVICE UNIT
- Practice address
- 232 Rustling Willow St
Towaoc, CO 81334-0049 - Phone
- (970) 565-4441
- Fax
- (970) 565-9110
- NPI assigned
- Mar 30, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Earl David Ward
- Title
- Health Center Director
- Phone
- (970) 565-4441
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federal Public Health Clinic/Center | 261QP0904X | Primary |
Addresses
Primary practice location
232 Rustling Willow St
Towaoc, CO 81334-0049
Mailing address
PO Box 49
Towaoc, CO 81334-0049
Phone (970) 565-4441
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G7123 | Medicaid | NM | |
| 70000000009 | Medicaid | UT | |
| 05600002 | Medicaid | CO | |
| 708000 | Medicaid | AZ |
Other names 1
- White Mesa Health Station
National Provider Directory
National Provider Directory- Tax ID family
- Ute Mountatin Ute Health Center
Other organizations with this tax ID 4
Organizations that report the same tax identification number in the National Provider Directory.
-
- Primary Care Clinic/Center
- Towaoc, CO
- NPI 1134313232
-
- Federal Public Health Clinic/Center
- Towaoc, CO
- NPI 1255422788
-
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Towaoc, CO
- NPI 1972670461
-
- Federally Qualified Health Center (FQHC)
- Towaoc, CO
- NPI 1619186558
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333065600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1333065600000",
"number": "1629344908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 49",
"city": "TOWAOC",
"state": "CO",
"postal_code": "813340049",
"telephone_number": "970-565-4441",
"fax_number": "970-565-9110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "232 RUSTLING WILLOW ST",
"city": "TOWAOC",
"state": "CO",
"postal_code": "813340049",
"telephone_number": "970-565-4441",
"fax_number": "970-565-9110"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTHERN COLORADO UTE SERVICE UNIT",
"organizational_subpart": "NO",
"enumeration_date": "2012-03-30",
"last_updated": "2012-03-30",
"status": "A",
"authorized_official_last_name": "WARD",
"authorized_official_first_name": "EARL",
"authorized_official_middle_name": "DAVID",
"authorized_official_title_or_position": "HEALTH CENTER DIRECTOR",
"authorized_official_telephone_number": "970-565-4441",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "261QP0904X",
"taxonomy_group": "",
"desc": "Clinic/Center, Public Health, Federal",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "G7123",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "70000000009",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "05600002",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "708000",
"state": "AZ"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "White Mesa Health Station",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Towaoc, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.