1639253321 NPI number — CASTLEVIEW HOSPITAL, LLC

Table of content: (NPI 1639253321)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639253321 NPI number — CASTLEVIEW HOSPITAL, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CASTLEVIEW HOSPITAL, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639253321
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/26/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 N HOSPITAL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PRICE
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84501-4218
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
435-636-4836
Provider Business Mailing Address Fax Number:
435-637-8819

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 N HOSPITAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PRICE
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84501-4218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
435-636-4836
Provider Business Practice Location Address Fax Number:
435-637-8819
Provider Enumeration Date:
10/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TEAGUE
Authorized Official First Name:
KATHY
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
SECRETARY
Authorized Official Telephone Number:
615-920-7000

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207R00000X , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 110179278 . This is a "EKG GROUP" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 47980 . This is a "PEHP EKG" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 497607255045 , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 43137085101001 . This is a "BCBS EKG" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 57268 . This is a "PEHP EKG" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 080168890 . This is a "EKG GROUP" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 62579 . This is a "PEHP EKG" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 110179277 . This is a "EKG GROUP" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 15042835401001 . This is a "BCBS EKG" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 52951335609001 . This is a "BCBS EKG" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: CI5032 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".




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