NPIMap

Organization Active NPI

The Memorial Hospital

Doing business as Community Pharmacy at Memorial Regional Health

  • Community/Retail Pharmacy
  • Craig, CO
National Provider Identifier
1326564246
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PDO.1680000152 Issued in CO
Legal business name
THE MEMORIAL HOSPITAL
Doing business as
Community Pharmacy at Memorial Regional Health
Practice address
750 Hospital Loop
Craig, CO 81625-8750
Phone
(970) 824-9411
Fax
(970) 826-3119
NPI assigned
Aug 22, 2017
Last updated
Apr 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Annalia Bailey
Title
Credentialer
Phone
(970) 824-9411

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Clinic Pharmacy 3336C0002X NU
Community/Retail Pharmacy 3336C0003X PDO.1680000152 CO Primary

Addresses

Primary practice location

750 Hospital Loop
Craig, CO 81625-8750

Mailing address

750 Hospital Loop
Craig, CO 81625-8750
Phone (970) 824-9411

Other identifiers 2

IdentifierTypeStateIssuer
9000156463MedicaidCO
2171012OtherPK

Other names 2

  • Community Pharmacy at Memorial Regional Health Doing business as
  • Community Clinics at Memorial Regional Health Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171128001373 CO Part B Supplier - Pharmacy 1254231533 Practice locations: Craig, CO

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
The Memorial Hospital10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712188800000",
    "number": "1326564246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 HOSPITAL LOOP",
            "city": "CRAIG",
            "state": "CO",
            "postal_code": "816258750",
            "telephone_number": "970-824-9411",
            "fax_number": "970-826-3119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 HOSPITAL LOOP",
            "city": "CRAIG",
            "state": "CO",
            "postal_code": "816258750",
            "telephone_number": "970-824-9411",
            "fax_number": "970-826-3119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-22",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "ANNALIA",
        "authorized_official_title_or_position": "CREDENTIALER",
        "authorized_official_telephone_number": "970-824-9411"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CO",
            "license": "PDO.1680000152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000156463",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2171012",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Pharmacy at Memorial Regional Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Clinics at Memorial Regional Health",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Craig, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.