Provider Demographics
NPI:1053731943
Name:GUNNISON VALLEY HOSPITAL
Entity type:Organization
Organization Name:GUNNISON VALLEY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-528-2146
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:435-528-2146
Mailing Address - Fax:435-528-2197
Practice Address - Street 1:10 WEST 400 SOUTH
Practice Address - Street 2:
Practice Address - City:CENTERFIELD
Practice Address - State:UT
Practice Address - Zip Code:84622
Practice Address - Country:US
Practice Address - Phone:435-528-3550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-18
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT465175Medicare Oscar/Certification