Provider Demographics
NPI:1548066178
Name:KREMMLING MEMORIAL HOSPITAL DISTRICT
Entity type:Organization
Organization Name:KREMMLING MEMORIAL HOSPITAL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:MARSHALL
Authorized Official - Last Name:CLECKLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-208-2907
Mailing Address - Street 1:PO BOX 399
Mailing Address - Street 2:
Mailing Address - City:KREMMLING
Mailing Address - State:CO
Mailing Address - Zip Code:80459-0399
Mailing Address - Country:US
Mailing Address - Phone:970-724-3442
Mailing Address - Fax:970-724-9606
Practice Address - Street 1:1000 GRANBY PARK DR S
Practice Address - Street 2:
Practice Address - City:GRANBY
Practice Address - State:CO
Practice Address - Zip Code:80446-5304
Practice Address - Country:US
Practice Address - Phone:970-724-3442
Practice Address - Fax:970-724-9606
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KREMMLING MEMORIAL HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty