Provider Demographics
NPI:1639253321
Name:CASTLEVIEW HOSPITAL, LLC
Entity Type:Organization
Organization Name:CASTLEVIEW HOSPITAL, LLC
Other - Org Name:CASTLEVIEW HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:TEAGUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-920-7000
Mailing Address - Street 1:300 N HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:PRICE
Mailing Address - State:UT
Mailing Address - Zip Code:84501-4218
Mailing Address - Country:US
Mailing Address - Phone:435-636-4836
Mailing Address - Fax:435-637-8819
Practice Address - Street 1:300 N HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501-4218
Practice Address - Country:US
Practice Address - Phone:435-636-4836
Practice Address - Fax:435-637-8819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT110179278OtherEKG GROUP
UT47980OtherPEHP EKG
UT497607255045Medicaid
UT43137085101001OtherBCBS EKG
UT57268OtherPEHP EKG
UT080168890OtherEKG GROUP
UT62579OtherPEHP EKG
UT110179277OtherEKG GROUP
UT15042835401001OtherBCBS EKG
UT52951335609001OtherBCBS EKG
UTCI5032OtherRAILROAD MEDICARE