Basic Information
| Provider Information | |||||||||
| NPI: | 1790978013 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GUNNISON VALLEY HOSPITAL AMBULANCE | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 759 | ||||||||
| Address2: | 64 EAST 100 NORTH | ||||||||
| City: | GUNNISON | ||||||||
| State: | UT | ||||||||
| PostalCode: | 84634 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4355287246 | ||||||||
| FaxNumber: | 4355282197 | ||||||||
| Practice Location | |||||||||
| Address1: | 64 EAST 100 NORTH | ||||||||
| Address2: | |||||||||
| City: | GUNNISON | ||||||||
| State: | UT | ||||||||
| PostalCode: | 84634 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4355287246 | ||||||||
| FaxNumber: | 4355282197 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2007 | ||||||||
| LastUpdateDate: | 04/20/2008 | ||||||||
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| AuthorizedOfficialLastName: | MURRAY | ||||||||
| AuthorizedOfficialFirstName: | BRIAN | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 4355287246 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3416L0300X | UT | Y | Transportation Services | Ambulance | Land Transport |
No ID Information.