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General NPI Number Information
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NPI Number | 1669446563
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Entity Type | Organization
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Legal Business Name | CACHE VALLEY SPECIALTY HOSPITAL
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Dates
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Enumeration Date | 02/15/2006
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Last Update Date | 07/29/2013
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Provider Practice Location Address
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Address Line | 2380 N 400 E
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City | NORTH LOGAN
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State | UT
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Zip | 84341-1749
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Country | US
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Telephone | 435-713-9700
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Fax | 435-753-8005
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Provider Business Mailing Address
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Address Line | 2380 N 400 E
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City | NORTH LOGAN
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State | UT
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Zip | 84341-6000
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Country | US
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Telephone | 435-713-9700
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Fax | 435-753-8005
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Authorized Official
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Title or Position | CFO
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Name | DAVID S GEARY
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Credential |
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Telephone | 435-713-9582
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 2005-HOSP-14503
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License Number State | UT
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