Provider Demographics
NPI:1861014284
Name:GUNNISON VALLEY HOSPITAL
Entity Type:Organization
Organization Name:GUNNISON VALLEY HOSPITAL
Other - Org Name:GUNNISON VALLEY HEALTH FAMILY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDERVEER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-642-4760
Mailing Address - Street 1:707 N IOWA ST
Mailing Address - Street 2:
Mailing Address - City:GUNNISON
Mailing Address - State:CO
Mailing Address - Zip Code:81230-2229
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:707 N IOWA ST
Practice Address - Street 2:
Practice Address - City:GUNNISON
Practice Address - State:CO
Practice Address - Zip Code:81230-2229
Practice Address - Country:US
Practice Address - Phone:970-642-8413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GUNNISON VALLEY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-07
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health