East Phillips County Hospital District
Organization Active NPI Land Ambulance · Holyoke, CO
NPI 1124787155 · NPPES record last updated Nov 22, 2024
Key facts
- NPI
- 1124787155
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- Legal business name
- EAST PHILLIPS COUNTY HOSPITAL DISTRICT
- Practice address
- 1001 E Johnson St
Holyoke, CO 80734-1854 - Phone
- (970) 854-2241
- Fax
- (970) 458-4581
- NPI assigned
- Dec 17, 2021
- Organization subpart
- No
Authorized official
- Name
- Michael Hassell
- Title
- Ceo
- Phone
- (970) 854-2241
Owned or controlled facilities with NPI records 3
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 8
Practitioners 17
-
Heather R Armstrong, MA LPC
-
Jessica Leigh Bullard, FNP-C
-
Pepper Knight Etters, PA-C
-
Sean Patrick Fitzgerald, MSN FNP-C
-
Anthony James Guglielmo, FNP-BC
-
Preston Keith Nein, M.D.
-
Jessica Rose Skomp, FNP-C
-
Eirawen Luettgen, ARNP, FNP, ENP
-
Craig Willard McCarty, M.D., PHD
-
Gary Dale Montgomery, PA-C
-
Amy Roden, NP-C
-
Angela Widler, PA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
All facility ownership & control disclosures 3
| Facility | Type | Role | Since |
|---|---|---|---|
| Melissa Memorial Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jul 11, 1966 |
| Melissa Memorial Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jul 11, 1966 |
| Family Practice of Holyoke |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 1966 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221215001398 | CO | Part B Supplier - Ambulance Service Supplier | 9638161615 |
1 other NPI on this enrollment Practice locations: Holyoke, CO |
National Provider Directory
- Tax ID family
- Melissa Memorial Hospital
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | |||
| Land Ambulance | 3416L0300X | Yes |
Addresses
Primary practice location
1001 E Johnson St
Holyoke, CO 80734-1854
Mailing address
1001 E Johnson St
Holyoke, CO 80734-1854
Phone (970) 854-2241
Other names
- Holyoke EMS
- Melissa Memorial Hospital
Other providers in Holyoke, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.