Provider Demographics
NPI:1710061411
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:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:GRACEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-372-8500
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:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT529609720024Medicaid
UT377024884001Medicaid
UT529609720024Medicaid
UT=========045Medicaid