Provider Demographics
NPI:1952046633
Name:JORDAN VALLEY & MOUNTAIN POINT MEDICAL CENTER, LLC
Entity Type:Organization
Organization Name:JORDAN VALLEY & MOUNTAIN POINT MEDICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIVISION CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GINGRAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-568-5995
Mailing Address - Street 1:3460 S PIONEER PKWY
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84120-2049
Mailing Address - Country:US
Mailing Address - Phone:801-964-3100
Mailing Address - Fax:
Practice Address - Street 1:3460 S PIONEER PKWY
Practice Address - Street 2:
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84120-2049
Practice Address - Country:US
Practice Address - Phone:801-964-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JORDAN VALLEY & MOUNTAIN POINT MEDICAL CENTER, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit