Healthcare Provider Details
I. General information
NPI: 1699716027
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: 06/09/2006
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2635 N 7TH ST
GRAND JUNCTION CO
81501-8209
US
IV. Provider business mailing address
2635 N 7TH ST
GRAND JUNCTION CO
81501-8209
US
V. Phone/Fax
- Phone: 970-298-2273
- Fax: 303-272-0277
- Phone: 970-298-2273
- Fax: 303-272-0277
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | 011160 |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 341600000X |
| Taxonomy | Ambulance |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3416A0800X |
| Taxonomy | Air Ambulance |
| License Number | A002 |
| License Number State | CO |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3416A0800X |
| Taxonomy | Air Ambulance |
| License Number | 3005L |
| License Number State | UT |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | 39-14-16 |
| License Number State | CO |
VIII. Authorized Official
Name:
VINCENT
DONOHUE
Title or Position: AVP FINANCE
Credential:
Phone: 970-298-7133