Healthcare Provider Details

I. General information

NPI: 1730897109
Provider Name (Legal Business Name): VALLEY VIEW HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2022
Last Update Date: 03/26/2023
Certification Date: 03/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 MARKET ST UNIT 201
BASALT CO
81621-7403
US

IV. Provider business mailing address

PO BOX 2270
GLENWOOD SPRINGS CO
81602-2270
US

V. Phone/Fax

Practice location:
  • Phone: 970-928-0808
  • Fax: 970-928-7591
Mailing address:
  • Phone: 970-928-0808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CHARLES CREVLING
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 970-384-6606