Healthcare Provider Details

I. General information

NPI: 1114654795
Provider Name (Legal Business Name): VALLEY VIEW HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2022
Last Update Date: 10/04/2022
Certification Date: 10/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1906 BLAKE AVE
GLENWOOD SPRINGS CO
81601-4259
US

IV. Provider business mailing address

PO BOX 2270
GLENWOOD SPRINGS CO
81602-2270
US

V. Phone/Fax

Practice location:
  • Phone: 970-945-6535
  • Fax:
Mailing address:
  • Phone: 970-384-7033
  • Fax: 970-945-5460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

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