Healthcare Provider Details

I. General information

NPI: 1063038628
Provider Name (Legal Business Name): GUNNISON VALLEY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2020
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 S MAIN ST
MANTI UT
84642-1351
US

IV. Provider business mailing address

PO BOX 759
GUNNISON UT
84634-0759
US

V. Phone/Fax

Practice location:
  • Phone: 435-835-7246
  • Fax:
Mailing address:
  • Phone: 435-528-2146
  • Fax: 435-528-2190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRIAN C. MURRAY
Title or Position: CFO
Credential:
Phone: 435-528-2146