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NPI Code Detail

MEDICARE: BEAVER VALLEY HOSPITAL

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
1261QP2000XPhysical Therapy Clinic/Center

General Provider Information

NPI Number : 1275049348
Entity Type Code : Organization
Provider Name (Legal Business Name) : BEAVER VALLEY HOSPITAL
Provider Business Mailing Address
First Line : 165 S 1000 E
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84102-1402
Country : US
Telephone Number : 801-322-5521
Fax Number : 801-322-0934
Provider Business Practice Location Address
First Line : 165 S 1000 E
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84102-1402
Country : US
Telephone Number : 801-322-5521
Fax Number : 801-322-0934
Authorized Official
Title or Position : DELEGATED OFFICIAL
Name : SOON BURNAM
Credential :
Telephone Number : 949-540-1249
Provider Enumeration Date : 12/27/2017
Last Update Date : 12/28/2017

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Directions to “BEAVER VALLEY HOSPITAL ” Practice Location

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