Organization
BESSA, INC
Active
Other names
Mt. View Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
EDWIN C BULLOCH (ADMINISTRATOR)
(435) 781-2335
Entity
Organization
Contact information
Practice address
209 N 300 W, VERNAL, UT 84078-1927
(435) 781-2335
(435) 781-0153
Mailing address
209 N 300 W, VERNAL, UT 84078-1927
(435) 781-2335
(435) 781-0153
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ESRD-22801
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22805000000001
BXBS PROVIDER #
UT
Enumeration date
02/06/2007
Last updated
08/22/2020
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