Basic Information
| Provider Information | |||||||||
| NPI: | 1063038628 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GUNNISON VALLEY HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 759 | ||||||||
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| City: | GUNNISON | ||||||||
| State: | UT | ||||||||
| PostalCode: | 846340759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4355282146 | ||||||||
| FaxNumber: | 4355282190 | ||||||||
| Practice Location | |||||||||
| Address1: | 46 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | MANTI | ||||||||
| State: | UT | ||||||||
| PostalCode: | 846421254 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4358357246 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2020 | ||||||||
| LastUpdateDate: | 06/19/2020 | ||||||||
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| AuthorizedOfficialLastName: | MURRAY | ||||||||
| AuthorizedOfficialFirstName: | BRIAN | ||||||||
| AuthorizedOfficialMiddleName: | C. | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 4355282146 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 06/19/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.