Beaver Valley Hospital

Organization Active NPI General Acute Care Hospital · Beaver, UT

NPI 1528066875 · NPPES record last updated May 18, 2017

Key facts

NPI
1528066875
Entity type
Organization (NPI type 2)
Primary specialty
General Acute Care Hospital 282N00000X
License
2004-HOSP-167 (UT)
Legal business name
BEAVER VALLEY HOSPITAL
Practice address
1109 N 100TH W
Beaver, UT 84713-1670
Phone
(435) 438-7100
Fax
(435) 438-7166
NPI assigned
Jul 11, 2005
Organization subpart
No

Authorized official

Name
Mr. Craig Val Davidson
Title
Administrator
Phone
(438) 438-7100

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in UT

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040927000930 UT Part B Supplier - Clinic/Group Practice 2769376326 Receives reassigned benefits from 8 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Beaver, UT

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 2006-HOSP-167 UT
General Acute Care Hospital 282N00000X 2004-HOSP-167 UT Yes

Addresses

Primary practice location

1109 N 100TH W
Beaver, UT 84713-1670

Mailing address

PO Box 1670
1109 N 100 W
Beaver, UT 84713-1670
Phone (435) 438-7100

Other identifiers

IdentifierTypeStateIssuer
000006972OtherUTPART B LEGACY OR PTAN #

Other providers in Beaver, UT

All providers in Beaver, UT · General Acute Care Hospital in Utah

Sources for this page

Verify at the official NPI Registry.