# BLUE MOUNTAIN HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558513812
- **Authorized official:** MR. JEREMY LYMAN MBA (CEO)
- **Authorized official phone:** (435) 678-3993

## Contact information

- **Practice address:** 802 S 200 WEST, SUITE A, BLANDING, UT 84511
- **Practice address phone:** (435) 678-3993
- **Practice address fax:** (435) 678-3992
- **Mailing address:** 802 S 200 WEST, SUITE A, BLANDING, UT 84511
- **Mailing address phone:** (435) 678-3993
- **Mailing address fax:** (435) 678-3992

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC0050X | Critical Access Hospital Clinic/Center | 2011-HOSP-96389 | UT | Yes |
| 261QE0700X | End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 2010-ESRD-90350 | UT | — |
| 275N00000X | Medicare Defined Swing Bed Hospital Unit | — | UT | — |

## Other

- **Enumeration date:** 10/17/2008
- **Last updated:** 09/19/2023