Healthcare Provider Details
I. General information
NPI: 1366477259
Provider Name (Legal Business Name): MERCY MEDICAL CENTER OF DURANGO
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/11/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1800 E 3RD AVE UNIT 10
DURANGO CO
81301-5016
US
IV. Provider business mailing address
1010 THREE SPRINGS BLVD
DURANGO CO
81301-8296
US
V. Phone/Fax
- Phone: 970-247-4311
- Fax:
- Phone: 970-247-4311
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0200X |
| Taxonomy | Radiology Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KIRK
A
DIGNUM
Title or Position: CEO/PRESIDENT
Credential:
Phone: 970-247-4311