# VAIL VALLEY SURGERY CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Vail Valley Surgery Center Vail
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003944125
- **Authorized official:** MS. JACQUELINE A DEVERIC (DIRECTOR)
- **Authorized official phone:** (970) 476-8202

## Contact information

- **Practice address:** 181 W MEADOW DR \# 3R, VAIL, CO 81657-5242
- **Practice address phone:** (970) 476-8200
- **Practice address fax:** (970) 477-8215
- **Mailing address:** PO BOX 1270, VAIL, CO 81658-1270
- **Mailing address phone:** (970) 477-8200
- **Mailing address fax:** (970) 477-8215

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 0704 | CO | Yes |

## Other

- **Enumeration date:** 03/01/2007
- **Last updated:** 04/12/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 67801731 | — | CO |