MEDICARE: BEAVER VALLEY HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	2005-NCF-443	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053318881
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEAVER VALLEY HOSPITAL

Provider Business Mailing Address
First Line	:	598 W 900 S STE 220
Second Line	:
City	:	WOODS CROSS
State	:	UT
Zip	:	84010-8195
Country	:	US
Telephone Number	:	801-397-4697
Fax Number	:	801-296-9117

Provider Business Practice Location Address
First Line	:	4090 W PIONEER PKWY
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84120-2060
Country	:	US
Telephone Number	:	801-397-4400
Fax Number	:	801-397-4490

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RAYMOND BEEMAN
Credential	:
Telephone Number	:	801-397-4000

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	01/10/2022

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Directions to “BEAVER VALLEY HOSPITAL ” Practice Location

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