Provider Demographics
NPI:1780978122
Name:VALLEY VIEW HOSPITAL ASSOCIATION
Entity type:Organization
Organization Name:VALLEY VIEW HOSPITAL ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:DUPPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-384-6605
Mailing Address - Street 1:377 SYLVAN LAKE ROAD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:EAGLE
Mailing Address - State:CO
Mailing Address - Zip Code:81631
Mailing Address - Country:US
Mailing Address - Phone:970-328-5646
Mailing Address - Fax:970-328-5674
Practice Address - Street 1:377 SYLVAN LAKE ROAD
Practice Address - Street 2:SUITE 140
Practice Address - City:EAGLE
Practice Address - State:CO
Practice Address - Zip Code:81631-4291
Practice Address - Country:US
Practice Address - Phone:970-328-5646
Practice Address - Fax:970-328-5674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-02
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38541207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1780978122OtherNPI