Provider Demographics
NPI:1710544663
Name:DELTA COUNTY MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:DELTA COUNTY MEMORIAL HOSPITAL
Other - Org Name:DELTA HEALTH PULMONOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CCO
Authorized Official - Prefix:
Authorized Official - First Name:JODY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-874-2256
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:970-399-2635
Mailing Address - Fax:970-399-2685
Practice Address - Street 1:70 STAFFORD LN
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416-2282
Practice Address - Country:US
Practice Address - Phone:970-399-2635
Practice Address - Fax:970-399-2685
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DELTA COUNTY MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-28
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty