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General NPI Number Information
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NPI Number | 1447920228
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Entity Type | Organization
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Legal Business Name | ST MARY'S HOSPITAL AND MEDICAL CENTER, INC
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Dates
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Enumeration Date | 09/14/2021
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Last Update Date | 10/26/2021
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Provider Practice Location Address
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Address Line | 562 29 RD
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City | GRAND JUNCTION
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State | CO
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Zip | 81504-8901
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Country | US
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Telephone | 970-985-7467
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Fax | 970-666-5125
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Provider Business Mailing Address
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Address Line | 500 ELDORADO BLVD STE 6300
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City | BROOMFIELD
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State | CO
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Zip | 80021-3422
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Country | US
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Telephone | 303-272-0566
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Fax | 303-272-0390
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Authorized Official
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Title or Position | VP FINANCE
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Name | TERRI L CHINN
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Credential |
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Telephone | 970-298-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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