=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093620874
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MONTROSE MEMORIAL HOSPITAL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/17/2026
-----------------------------------------------------
Last Update Date | 08/17/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 901 S. FOURTH ST.
-----------------------------------------------------
City | MONTROSE
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81401
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-249-6641
-----------------------------------------------------
Fax | 970-249-5148
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 800 S 3RD ST
-----------------------------------------------------
City | MONTROSE
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81401-4212
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-252-2838
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ANALYST IV
-----------------------------------------------------
Name | SARA ANN SELF
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 970-252-2838
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------