Provider Demographics
NPI: | 1043968282 |
---|---|
Name: | VALLEY VIEW HOSPITAL ASSOCIATION |
Entity type: | Organization |
Organization Name: | VALLEY VIEW HOSPITAL ASSOCIATION |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | CFO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | CHARLES |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | CREVLING |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 970-384-6606 |
Mailing Address - Street 1: | PO BOX 2270 |
Mailing Address - Street 2: | |
Mailing Address - City: | GLENWOOD SPRINGS |
Mailing Address - State: | CO |
Mailing Address - Zip Code: | 81602-2270 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 970-384-7033 |
Mailing Address - Fax: | 970-945-5460 |
Practice Address - Street 1: | 195 FREESTONE RD |
Practice Address - Street 2: | |
Practice Address - City: | EAGLE |
Practice Address - State: | CO |
Practice Address - Zip Code: | 81631-5930 |
Practice Address - Country: | US |
Practice Address - Phone: | 970-328-6357 |
Practice Address - Fax: | 970-328-5633 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | VALLEY VIEW HOSPITAL ASSOCIATION |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2022-03-16 |
Last Update Date: | 2022-05-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Single Specialty |