Healthcare Provider Details

I. General information

NPI: 1932838562
Provider Name (Legal Business Name): DELTA COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2022
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 STAFFORD LN
DELTA CO
81416-3465
US

IV. Provider business mailing address

PO BOX 10100
DELTA CO
81416-0008
US

V. Phone/Fax

Practice location:
  • Phone: 970-874-8026
  • Fax: 970-874-5430
Mailing address:
  • Phone: 970-874-7681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN COHEE
Title or Position: CEO
Credential: CEO
Phone: 970-874-2285