Healthcare Provider Details

I. General information

NPI: 1609443167
Provider Name (Legal Business Name): THE MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2021
Last Update Date: 03/20/2024
Certification Date: 03/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 W VICTORY WAY
CRAIG CO
81625-3440
US

IV. Provider business mailing address

750 HOSPITAL LOOP
CRAIG CO
81625-8750
US

V. Phone/Fax

Practice location:
  • Phone: 970-826-8300
  • Fax:
Mailing address:
  • Phone: 970-824-9411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANNALIA BAILEY
Title or Position: PROVIDER RELATION COORDINATOR
Credential:
Phone: 970-824-9411