Provider Demographics
NPI:1467507269
Name:TOC, INC.
Entity type:Organization
Organization Name:TOC, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:LAVON
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-874-6115
Mailing Address - Street 1:108 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:DELTA
Mailing Address - State:CO
Mailing Address - Zip Code:81416-1802
Mailing Address - Country:US
Mailing Address - Phone:970-874-6115
Mailing Address - Fax:970-874-6979
Practice Address - Street 1:7405 W US HIGHWAY 50
Practice Address - Street 2:#123
Practice Address - City:SALIDA
Practice Address - State:CO
Practice Address - Zip Code:81201-9353
Practice Address - Country:US
Practice Address - Phone:719-539-4090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10M587251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO21972583Medicaid
CO74731581Medicaid