Organization
VAIL VALLEY SURGERY CENTER, LLC
Active
Other names
Vail Valley Surgery Center Vail
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACQUELINE A DEVERIC (DIRECTOR)
(970) 476-8202
Entity
Organization
Contact information
Practice address
181 W MEADOW DR # 3R, VAIL, CO 81657-5242
(970) 476-8200
(970) 477-8215
Mailing address
PO BOX 1270, VAIL, CO 81658-1270
(970) 477-8200
(970) 477-8215
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0704
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
67801731
—
CO
Enumeration date
03/01/2007
Last updated
04/12/2012
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