Healthcare Provider Details

I. General information

NPI: 1124499769
Provider Name (Legal Business Name): GUNNISON VALLEY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2015
Last Update Date: 10/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 E MAIN ST # 3
SALINA UT
84654-1335
US

IV. Provider business mailing address

PO BOX 343
SALINA UT
84654-0343
US

V. Phone/Fax

Practice location:
  • Phone: 435-529-2215
  • Fax: 435-529-2094
Mailing address:
  • Phone: 435-529-2215
  • Fax: 435-529-2094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number293477-4405
License Number StateUT

VIII. Authorized Official

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