Provider Demographics
NPI:1609443167
Name:THE MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:THE MEMORIAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROVIDER RELATION COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-824-9411
Mailing Address - Street 1:750 HOSPITAL LOOP
Mailing Address - Street 2:
Mailing Address - City:CRAIG
Mailing Address - State:CO
Mailing Address - Zip Code:81625-8750
Mailing Address - Country:US
Mailing Address - Phone:970-824-9411
Mailing Address - Fax:
Practice Address - Street 1:2020 W VICTORY WAY
Practice Address - Street 2:
Practice Address - City:CRAIG
Practice Address - State:CO
Practice Address - Zip Code:81625-3440
Practice Address - Country:US
Practice Address - Phone:970-826-8300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-04
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health