Provider Demographics
NPI:1043884208
Name:VAIL CLINIC INC
Entity type:Organization
Organization Name:VAIL CLINIC INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SVP & CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-479-7272
Mailing Address - Street 1:PO BOX 840220
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-0220
Mailing Address - Country:US
Mailing Address - Phone:970-777-2850
Mailing Address - Fax:
Practice Address - Street 1:365 DILLON RIDGE RD
Practice Address - Street 2:STE 100
Practice Address - City:DILLON
Practice Address - State:CO
Practice Address - Zip Code:80435-6343
Practice Address - Country:US
Practice Address - Phone:970-479-7272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VAIL CLINIC INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-13
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies