Provider Demographics
NPI:1093712929
Name:BCBU, INC.
Entity Type:Organization
Organization Name:BCBU, INC.
Other - Org Name:ROCKY MOUNTAIN CARE - BOUNTIFUL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DEE
Authorized Official - Middle Name:R
Authorized Official - Last Name:BANGERTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-397-4000
Mailing Address - Street 1:576 W. 900 S.
Mailing Address - Street 2:SUITE 260
Mailing Address - City:WOODS CROSS
Mailing Address - State:UT
Mailing Address - Zip Code:84010-8127
Mailing Address - Country:US
Mailing Address - Phone:801-397-4600
Mailing Address - Fax:801-397-4196
Practice Address - Street 1:576 W. 900 S.
Practice Address - Street 2:SUITE 260
Practice Address - City:WOODS CROSS
Practice Address - State:UT
Practice Address - Zip Code:84010-8127
Practice Address - Country:US
Practice Address - Phone:801-397-4054
Practice Address - Fax:801-397-4196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT465068Medicare ID - Type Unspecified
UT=========004Medicaid