Provider Demographics
NPI:1164562732
Name:SOUTH DAVIS COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:SOUTH DAVIS COMMUNITY HOSPITAL
Other - Org Name:ORCHARD COVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-295-2361
Mailing Address - Street 1:401 S 400 E
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-4933
Mailing Address - Country:US
Mailing Address - Phone:801-295-2361
Mailing Address - Fax:801-295-1398
Practice Address - Street 1:485 E 500 S
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-3801
Practice Address - Country:US
Practice Address - Phone:801-299-4800
Practice Address - Fax:801-299-4850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3104A0630X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances