Healthcare Provider Details
I. General information
NPI: 1992502033
Provider Name (Legal Business Name): KREMMLING MEMORIAL HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/26/2025
Last Update Date: 02/26/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
31 TELEMARK DRIVE
FRASER CO
80442-0000
US
IV. Provider business mailing address
PO BOX 399
KREMMLING CO
80459-0399
US
V. Phone/Fax
- Phone: 970-887-5800
- Fax: 970-887-5891
- Phone: 970-887-5800
- Fax: 970-887-5891
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JASON
MARSHALL
CLECKLER
Title or Position: CEO
Credential:
Phone: 970-208-2907