Healthcare Provider Details

I. General information

NPI: 1699399238
Provider Name (Legal Business Name): ST MARY'S HOSPITAL AND MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2020
Last Update Date: 01/29/2024
Certification Date: 01/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2635 N 7TH ST UNIT 4
GRAND JUNCTION CO
81501-8209
US

IV. Provider business mailing address

2635 N 7TH ST UNIT 4
GRAND JUNCTION CO
81501-8209
US

V. Phone/Fax

Practice location:
  • Phone: 970-298-1995
  • Fax: 970-298-1992
Mailing address:
  • Phone: 970-298-1995
  • Fax: 970-298-1992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY THUROW
Title or Position: VP FINANCE
Credential:
Phone: 970-298-7133