Organization
BLUE MOUNTAIN HOSPITAL
Active
Other names
Dialysis Unit
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY LYMAN MBA (CEO)
(435) 678-3993
Entity
Organization
Contact information
Practice address
802 S 200 W, SUITE A, BLANDING, UT 84511
(435) 678-3993
(435) 678-3992
Mailing address
802 S 200 W, SUITE A, BLANDING, UT 84511
(435) 678-3993
(435) 678-3992
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
2012-ESRD-90350
UT
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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Other
Enumeration date
05/29/2009
Last updated
05/12/2014
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