Healthcare Provider Details

I. General information

NPI: 1740137637
Provider Name (Legal Business Name): BEAVER VALLEY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3430 HARRISON BLVD
OGDEN UT
84403-1231
US

IV. Provider business mailing address

3430 HARRISON BLVD
OGDEN UT
84403-1231
US

V. Phone/Fax

Practice location:
  • Phone: 801-399-5609
  • Fax: 801-627-1808
Mailing address:
  • Phone: 801-399-5609
  • Fax: 801-627-1808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: SOON BURNAM
Title or Position: SECRETARY OF MANAGEMENT COMPANY
Credential:
Phone: 949-540-1249