1780978122 NPI number — VALLEY VIEW HOSPITAL ASSOCIATION

Table of content: (NPI 1780978122)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780978122 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:
Provider Other Organization Name Type Code:
6
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:
1780978122
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/17/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
377 SYLVAN LAKE ROAD
Provider Second Line Business Mailing Address:
SUITE 140
Provider Business Mailing Address City Name:
EAGLE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81631
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-328-5646
Provider Business Mailing Address Fax Number:
970-328-5674

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
377 SYLVAN LAKE ROAD
Provider Second Line Business Practice Location Address:
SUITE 140
Provider Business Practice Location Address City Name:
EAGLE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81631-4291
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-328-5646
Provider Business Practice Location Address Fax Number:
970-328-5674
Provider Enumeration Date:
06/02/2011

Additional Information

Authorized Official

Authorized Official Last Name:
DUPPER
Authorized Official First Name:
LARRY
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
970-384-6605

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  38541 , 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: 1780978122 . This is a "NPI" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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