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General NPI Number Information
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NPI Number | 1962092551
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Entity Type | Organization
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Legal Business Name | MOUNTAIN VIEW HOSPITAL LLC
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Dates
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Enumeration Date | 01/19/2021
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 404 N 2ND E
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City | REXBURG
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State | ID
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Zip | 83440-1608
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Country | US
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Telephone | 208-359-1770
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Fax | 208-359-1780
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Provider Business Mailing Address
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Address Line | 404 N 2ND E
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City | REXBURG
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State | ID
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Zip | 83440-1608
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Country | US
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Telephone | 208-359-1770
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Fax | 208-359-1780
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Authorized Official
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Title or Position | CCO
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Name | NED W HILLYARD
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Credential |
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Telephone | 208-709-4571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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