Provider Demographics
NPI:1366477259
Name:MERCY MEDICAL CENTER OF DURANGO
Entity type:Organization
Organization Name:MERCY MEDICAL CENTER OF DURANGO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:A
Authorized Official - Last Name:DIGNUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-247-4311
Mailing Address - Street 1:1010 THREE SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-8296
Mailing Address - Country:US
Mailing Address - Phone:970-247-4311
Mailing Address - Fax:
Practice Address - Street 1:1800 E 3RD AVE
Practice Address - Street 2:UNIT 10
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5016
Practice Address - Country:US
Practice Address - Phone:970-247-4311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Not Answered291U00000XLaboratoriesClinical Medical Laboratory