Provider Demographics
NPI:1760031710
Name:ASPEN VALLEY HOSPITAL CLINICS, PLLC
Entity Type:Organization
Organization Name:ASPEN VALLEY HOSPITAL CLINICS, PLLC
Other - Org Name:ASPEN VALLEY HOSPITAL CENTER FOR MEDICAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KNOWLES
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, CHC
Authorized Official - Phone:970-544-1551
Mailing Address - Street 1:1460 E VALLEY RD STE 103
Mailing Address - Street 2:
Mailing Address - City:BASALT
Mailing Address - State:CO
Mailing Address - Zip Code:81621-8412
Mailing Address - Country:US
Mailing Address - Phone:970-279-4111
Mailing Address - Fax:
Practice Address - Street 1:1460 E VALLEY RD
Practice Address - Street 2:SUITE 101
Practice Address - City:BASALT
Practice Address - State:CO
Practice Address - Zip Code:81621-8412
Practice Address - Country:US
Practice Address - Phone:970-279-4111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-11
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty