Healthcare Provider Details
I. General information
NPI: 1740825397
Provider Name (Legal Business Name): VALLEY VIEW HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/07/2019
Last Update Date: 11/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1450 E VALLEY RD UNIT 202
BASALT CO
81621-8352
US
IV. Provider business mailing address
1906 BLAKE AVE
GLENWOOD SPRINGS CO
81601-4227
US
V. Phone/Fax
- Phone: 970-384-7100
- Fax: 970-384-8119
- Phone: 970-384-7100
- Fax: 970-384-8119
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| 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: CFO
Credential:
Phone: 970-384-6606