Provider Demographics
NPI:1033763818
Name:COMMUNITY CLINICS AT MEMORIAL REGIONAL HEALTH
Entity Type:Organization
Organization Name:COMMUNITY CLINICS AT MEMORIAL REGIONAL HEALTH
Other - Org Name:COMMUNITY PHARMACY AT STEAMBOAT SPRINGS
Other - Org Type:Other Name
Authorized Official - Title/Position:VP OF CLINICAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:970-826-3107
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:970-826-3119
Practice Address - Street 1:2201 CURVE PLAZA
Practice Address - Street 2:A101
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-5194
Practice Address - Country:US
Practice Address - Phone:970-826-8440
Practice Address - Fax:970-826-8449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-30
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy