Healthcare Provider Details

I. General information

NPI: 1902552805
Provider Name (Legal Business Name): VAIL CLINIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2022
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 DILLON RIDGE RD STE 100
DILLON CO
80435-6343
US

IV. Provider business mailing address

PO BOX 840220
KANSAS CITY MO
64184-0220
US

V. Phone/Fax

Practice location:
  • Phone: 970-476-1225
  • Fax:
Mailing address:
  • Phone: 970-777-2850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL G BROWN
Title or Position: SVP & CFO
Credential:
Phone: 970-479-7272