Healthcare Provider Details

I. General information

NPI: 1053433607
Provider Name (Legal Business Name): BCBU, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 N 1680 E STE V1
ST GEORGE UT
84790-2579
US

IV. Provider business mailing address

576 W 900 S SUITE 260
WOODS CROSS UT
84010-8194
US

V. Phone/Fax

Practice location:
  • Phone: 435-673-6699
  • Fax: 435-656-1190
Mailing address:
  • Phone: 801-397-4100
  • Fax: 801-397-4197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number2005-HHA-569
License Number StateUT

VIII. Authorized Official

Name: DEE R BANGERTER
Title or Position: PRESIDENT
Credential:
Phone: 801-397-4000