Healthcare Provider Details

I. General information

NPI: 1114698453
Provider Name (Legal Business Name): MONTROSE MEMORIAL HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2021
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 PALMER ST
DELTA CO
81416-1735
US

IV. Provider business mailing address

800 S 3RD ST
MONTROSE CO
81401-4212
US

V. Phone/Fax

Practice location:
  • Phone: 970-249-6737
  • Fax: 970-252-0112
Mailing address:
  • Phone: 970-249-6737
  • Fax: 970-252-0112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MEGAN BEAVER
Title or Position: PFS ANAYLST
Credential:
Phone: 970-252-2691