1619118064 NPI number — VALLEY VIEW HOSPITAL ASSOCIATION

Table of content: (NPI 1619118064)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619118064 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:
CALAWAY YOUNG CANCER 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:
1619118064
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/12/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2270
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLENWOOD SPGS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81602-2270
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-384-7033
Provider Business Mailing Address Fax Number:
970-945-5460

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1906 BLAKE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLENWOOD SPGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81601-4298
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-384-7290
Provider Business Practice Location Address Fax Number:
970-384-7293
Provider Enumeration Date:
03/16/2009

Additional Information

Authorized Official

Authorized Official Last Name:
CREVLING
Authorized Official First Name:
CHARLES
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
970-384-6606

Provider Taxonomy Codes

  • Taxonomy code: 207RX0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X , with the licence number: 0886 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208M00000X , with the licence number: 0886 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 38033518 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com