Healthcare Provider Details

I. General information

NPI: 1033757901
Provider Name (Legal Business Name): ASPEN VALLEY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2019
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 EAST VALLEY ROAD SUITE 101 NUTRITION SERVICES/DIABETES EDUCATION
BASALT CO
81621
US

IV. Provider business mailing address

401 CASTLE CREEK ROAD COMPLIANCE OFFICE
ASPEN CO
81611-1159
US

V. Phone/Fax

Practice location:
  • Phone: 970-544-7394
  • Fax:
Mailing address:
  • Phone: 970-544-1551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: STEVEN KNOWLES
Title or Position: COMPLIANCE OFFICER
Credential:
Phone: 970-544-1551