Healthcare Provider Details

I. General information

NPI: 1063805919
Provider Name (Legal Business Name): VALLEY VIEW HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2015
Last Update Date: 11/18/2020
Certification Date: 11/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1906 BLAKE AVE
GLENWOOD SPGS CO
81601-4227
US

IV. Provider business mailing address

1906 BLAKE AVE
GLENWOOD SPGS CO
81601-4227
US

V. Phone/Fax

Practice location:
  • Phone: 970-384-7100
  • Fax: 970-384-8119
Mailing address:
  • Phone: 970-384-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: CHARLES CREVLING
Title or Position: CFO
Credential:
Phone: 970-384-6606