Organization
BEAVER VALLEY HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CRAIG VAL DAVIDSON (ADMINISTRATOR)
(438) 438-7100
Entity
Organization
Contact information
Practice address
1109 N 100TH W, BEAVER, UT 84713-1670
(435) 438-7100
(435) 438-7166
Mailing address
PO BOX 1670, 1109 N 100 W, BEAVER, UT 84713-1670
(435) 438-7100
(435) 438-7166
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
2006-HOSP-167
UT
282N00000X
General Acute Care Hospital
Primary
2004-HOSP-167
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000006972
PART B LEGACY OR PTAN #
UT
Enumeration date
07/11/2005
Last updated
05/18/2017
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