Provider Demographics
NPI:1720470974
Name:JORDAN VALLEY MEDICAL CENTER LP
Entity Type:Organization
Organization Name:JORDAN VALLEY MEDICAL CENTER LP
Other - Org Name:MOUNTAIN POINT MEDICAL CENTER, A CAMPUS OF JORDAN VALLEY MEDICAL CENTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HOSPITAL CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-636-6597
Mailing Address - Street 1:3000 N TRIUMPH BLVD
Mailing Address - Street 2:ATTN: BILLING
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-4999
Mailing Address - Country:US
Mailing Address - Phone:385-345-3000
Mailing Address - Fax:385-345-3313
Practice Address - Street 1:3000 N. TRIUMPH BOULEVARD
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-4999
Practice Address - Country:US
Practice Address - Phone:385-345-3000
Practice Address - Fax:801-768-9552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-25
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT460051Medicare Oscar/Certification