Basic Information
| Provider Information | |||||||||
| NPI: | 1033159603 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JORDAN VALLEY MEDICAL CENTER LP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3580 W 9000 S | ||||||||
| Address2: | ATTN: BILLING | ||||||||
| City: | WEST JORDAN | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840888812 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015618888 | ||||||||
| FaxNumber: | 8015698723 | ||||||||
| Practice Location | |||||||||
| Address1: | 3580 W 9000 S | ||||||||
| Address2: | |||||||||
| City: | WEST JORDAN | ||||||||
| State: | UT | ||||||||
| PostalCode: | 840888899 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015618888 | ||||||||
| FaxNumber: | 8015624294 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2006 | ||||||||
| LastUpdateDate: | 04/04/2018 | ||||||||
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| AuthorizedOfficialLastName: | ANDERSON | ||||||||
| AuthorizedOfficialFirstName: | STEVEN | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8015618888 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 2005-HOSP-810 | UT | Y | Hospitals | General Acute Care Hospital |
No ID Information.