Healthcare Provider Details

I. General information

NPI: 1639842255
Provider Name (Legal Business Name): GUNNISON VALLEY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2021
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 S MAIN ST
MANTI UT
84642-1351
US

IV. Provider business mailing address

156 S MAIN ST
MANTI UT
84642-1351
US

V. Phone/Fax

Practice location:
  • Phone: 435-835-7250
  • Fax: 435-835-7249
Mailing address:
  • Phone: 435-835-7250
  • Fax: 435-835-7249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

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