Healthcare Provider Details

I. General information

NPI: 1417336637
Provider Name (Legal Business Name): MONUMENT HEALTH NETWORK, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2015
Last Update Date: 03/16/2020
Certification Date: 03/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 WASHINGTON BLVD
NEWCASTLE WY
82701-2968
US

IV. Provider business mailing address

PO BOX 860013
MINNEAPOLIS MN
55486-0013
US

V. Phone/Fax

Practice location:
  • Phone: 307-746-6720
  • Fax: 605-718-7082
Mailing address:
  • Phone: 307-746-6720
  • Fax: 605-718-7082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: THOMAS WORSLEY
Title or Position: PRESIDENT SPEARFISH HOSPITAL
Credential:
Phone: 307-746-6720