Healthcare Provider Details

I. General information

NPI: 1629075361
Provider Name (Legal Business Name): BEAVER VALLEY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 01/04/2022
Certification Date: 01/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1481 E 1450 S
CLEARFIELD UT
84015-1610
US

IV. Provider business mailing address

598 W 900 S STE 220
WOODS CROSS UT
84010-8195
US

V. Phone/Fax

Practice location:
  • Phone: 801-397-4300
  • Fax: 801-397-4390
Mailing address:
  • Phone: 801-397-4697
  • Fax: 801-296-9117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number2005-NCF-442
License Number StateUT

VIII. Authorized Official

Name: DANNY SETJO
Title or Position: BOARD PRESIDENT
Credential:
Phone: 801-397-4000