Provider Demographics
NPI:1568638427
Name:MONTROSE REGIONAL CANCER CARE
Entity type:Organization
Organization Name:MONTROSE REGIONAL CANCER CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-252-2691
Mailing Address - Street 1:2233 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-3831
Mailing Address - Country:US
Mailing Address - Phone:970-765-0818
Mailing Address - Fax:970-497-8410
Practice Address - Street 1:600 S 5TH ST
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-5711
Practice Address - Country:US
Practice Address - Phone:970-240-7242
Practice Address - Fax:970-240-7793
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MONTROSE MEMORIAL HOSPITAL, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-01
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO23620340Medicaid