Healthcare Provider Details

I. General information

NPI: 1619962321
Provider Name (Legal Business Name): KREMMLING MEMORIAL HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 09/07/2020
Certification Date: 09/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 S.4TH STREET
KREMMLING CO
80459
US

IV. Provider business mailing address

PO BOX 399
KREMMLING CO
80459-0399
US

V. Phone/Fax

Practice location:
  • Phone: 970-724-3171
  • Fax: 970-724-9606
Mailing address:
  • Phone: 970-724-3171
  • Fax: 970-724-9606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number0127
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number0127
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number00.0000156
License Number StateCO

VIII. Authorized Official

Name: MIKEALENA HORNER
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 970-724-3171