1790387850 NPI number — VALLEY VIEW HOSPITAL ASSOCIATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790387850 NPI number — VALLEY VIEW HOSPITAL ASSOCIATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VALLEY VIEW HOSPITAL ASSOCIATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790387850
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/13/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1906 BLAKE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLENWOOD SPRINGS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81601-4227
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-384-7579
Provider Business Mailing Address Fax Number:
970-384-8131

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 PIONEERS MEDICAL CENTER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEEKER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81641-3181
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-384-7579
Provider Business Practice Location Address Fax Number:
970-384-8131
Provider Enumeration Date:
11/13/2020

Additional Information

Authorized Official

Authorized Official Last Name:
CREVLING
Authorized Official First Name:
CHARLES
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
970-384-6606

Provider Taxonomy Codes

  • Taxonomy code: 207RX0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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