Healthcare Provider Details

I. General information

NPI: 1730696717
Provider Name (Legal Business Name): BEAVER VALLEY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2017
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1032 E 100 S
ST GEORGE UT
84770-3005
US

IV. Provider business mailing address

1032 E 100 S
ST GEORGE UT
84770-3005
US

V. Phone/Fax

Practice location:
  • Phone: 435-628-0488
  • Fax: 435-628-1145
Mailing address:
  • Phone: 435-628-0488
  • Fax: 435-628-1145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SOON BURNAM
Title or Position: DELEGATED OFFICIAL
Credential:
Phone: 949-540-1249