Provider Demographics
NPI:1952463036
Name:GUNNISON VALLEY HOSPITAL
Entity Type:Organization
Organization Name:GUNNISON VALLEY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-528-7246
Mailing Address - Street 1:PO BOX 759
Mailing Address - Street 2:
Mailing Address - City:GUNNISON
Mailing Address - State:UT
Mailing Address - Zip Code:84634-0759
Mailing Address - Country:US
Mailing Address - Phone:435-528-7246
Mailing Address - Fax:435-528-2197
Practice Address - Street 1:64 EAST 100 NORTH
Practice Address - Street 2:
Practice Address - City:GUNNISON
Practice Address - State:UT
Practice Address - Zip Code:84634
Practice Address - Country:US
Practice Address - Phone:435-528-7246
Practice Address - Fax:435-528-2197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2006-HOSP-183282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========005Medicaid
UT461306Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER