1053956540 NPI number — VALLEY VIEW HOSPITAL ASSOCIATION

Table of content: DR. DANIEL SHELLY DPT, ATC (NPI 1881095321)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053956540 NPI number — VALLEY VIEW HOSPITAL ASSOCIATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VALLEY VIEW HOSPITAL ASSOCIATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
THE LUNG CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053956540
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1906 BLAKE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLENWOOD SPRINGS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81601-4227
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-384-7707
Provider Business Mailing Address Fax Number:
970-384-8141

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
350 MARKET ST UNIT 201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BASALT
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81621-7403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-384-7707
Provider Business Practice Location Address Fax Number:
970-384-8141
Provider Enumeration Date:
11/08/2019

Additional Information

Authorized Official

Authorized Official Last Name:
MOORE
Authorized Official First Name:
SARAH
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
970-384-6874

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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