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General NPI Number Information
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NPI Number | 1629075361
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Entity Type | Organization
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Legal Business Name | BEAVER VALLEY HOSPITAL
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 01/04/2022
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Provider Practice Location Address
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Address Line | 1481 E 1450 S
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City | CLEARFIELD
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State | UT
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Zip | 84015-1610
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Country | US
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Telephone | 801-397-4300
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Fax | 801-397-4390
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Provider Business Mailing Address
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Address Line | 598 W 900 S STE 220
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City | WOODS CROSS
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State | UT
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Zip | 84010-8195
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Country | US
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Telephone | 801-397-4697
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Fax | 801-296-9117
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Authorized Official
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Title or Position | BOARD PRESIDENT
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Name | DANNY SETJO
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Credential |
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Telephone | 801-397-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 2005-NCF-442
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License Number State | UT
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