Healthcare Provider Details
I. General information
NPI: 1275804890
Provider Name (Legal Business Name): VALLEY VIEW HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/13/2012
Last Update Date: 04/28/2021
Certification Date: 04/28/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
978 EUCLID AVENUE
CARBONDALE CO
81623-1839
US
IV. Provider business mailing address
978 EUCLID AVENUE
CARBONDALE CO
81623-1839
US
V. Phone/Fax
- Phone: 970-963-3350
- Fax:
- Phone: 970-963-3350
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHARLES
CREVLING
Title or Position: CFO
Credential:
Phone: 970-384-6606