Provider Demographics
NPI:1114778412
Name:ASPEN VALLEY HOSPITAL DISTRICT CLINICS
Entity Type:Organization
Organization Name:ASPEN VALLEY HOSPITAL DISTRICT CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KNOWLES
Authorized Official - Suffix:
Authorized Official - Credentials:RN,CHC
Authorized Official - Phone:970-544-1551
Mailing Address - Street 1:401 CASTLE CREEK RD OFC
Mailing Address - Street 2:
Mailing Address - City:ASPEN
Mailing Address - State:CO
Mailing Address - Zip Code:81611-1159
Mailing Address - Country:US
Mailing Address - Phone:970-544-1551
Mailing Address - Fax:
Practice Address - Street 1:234 CODY LN
Practice Address - Street 2:
Practice Address - City:BASALT
Practice Address - State:CO
Practice Address - Zip Code:81621-9106
Practice Address - Country:US
Practice Address - Phone:970-544-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Multi-Specialty