Provider Demographics
NPI:1669857116
Name:VALLEY VIEW HOSPITAL ASSOCIATION
Entity Type:Organization
Organization Name:VALLEY VIEW HOSPITAL ASSOCIATION
Other - Org Name:INTERNAL MEDICINE AT VALLEY VIEW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:CREVLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-384-6606
Mailing Address - Street 1:PO BOX 2270
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81602-2270
Mailing Address - Country:US
Mailing Address - Phone:970-384-6707
Mailing Address - Fax:970-384-8128
Practice Address - Street 1:1830 BLAKE AVE STE 101
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-4275
Practice Address - Country:US
Practice Address - Phone:970-384-6707
Practice Address - Fax:970-384-8128
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VALLEY VIEW HOSPITAL ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-27
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO11331861Medicaid
CO7586280005Medicare NSC
COCOB4599Medicare PIN