Provider Demographics
NPI:1326630336
Name:DELTA COUNTY MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:DELTA COUNTY MEMORIAL HOSPITAL
Other - Org Name:DELTA HEALTH PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:HEYN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-874-7681
Mailing Address - Street 1:PO BOX 10100
Mailing Address - Street 2:
Mailing Address - City:DELTA
Mailing Address - State:CO
Mailing Address - Zip Code:81416-0008
Mailing Address - Country:US
Mailing Address - Phone:970-546-4000
Mailing Address - Fax:970-546-4001
Practice Address - Street 1:296 STAFFORD LN
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416-2243
Practice Address - Country:US
Practice Address - Phone:970-546-4000
Practice Address - Fax:970-546-4001
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DELTA COUNTY MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-10
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty