Provider Demographics
NPI:1508816224
Name:PASCO/SW INC
Entity Type:Organization
Organization Name:PASCO/SW INC
Other - Org Name:PASCO/SW HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:YVETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:TANNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-565-6833
Mailing Address - Street 1:45 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:CORTEZ
Mailing Address - State:CO
Mailing Address - Zip Code:81321-3737
Mailing Address - Country:US
Mailing Address - Phone:970-565-6833
Mailing Address - Fax:970-564-8057
Practice Address - Street 1:45 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CORTEZ
Practice Address - State:CO
Practice Address - Zip Code:81321-3737
Practice Address - Country:US
Practice Address - Phone:970-565-6833
Practice Address - Fax:970-564-8057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO06259588Medicaid
CO09559787Medicaid
CO06259588Medicaid