Healthcare Provider Details

I. General information

NPI: 1093338840
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: 05/27/2020
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2698 PATTERSON RD UNIT 42
GRAND JUNCTION CO
81506-8818
US

IV. Provider business mailing address

2698 PATTERSON RD UNIT 42
GRAND JUNCTION CO
81506-8818
US

V. Phone/Fax

Practice location:
  • Phone: 970-298-2800
  • Fax: 970-298-6902
Mailing address:
  • Phone: 970-298-2800
  • Fax: 970-298-6902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: TERRI L CHINN
Title or Position: VP OF FINANCE
Credential:
Phone: 970-298-2020