Provider Demographics
NPI:1962092551
Name:MOUNTAIN VIEW HOSPITAL LLC
Entity type:Organization
Organization Name:MOUNTAIN VIEW HOSPITAL LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CCO
Authorized Official - Prefix:
Authorized Official - First Name:NED
Authorized Official - Middle Name:W
Authorized Official - Last Name:HILLYARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-709-4571
Mailing Address - Street 1:404 N 2ND E
Mailing Address - Street 2:
Mailing Address - City:REXBURG
Mailing Address - State:ID
Mailing Address - Zip Code:83440-1608
Mailing Address - Country:US
Mailing Address - Phone:208-359-1770
Mailing Address - Fax:208-359-1780
Practice Address - Street 1:404 N 2ND E
Practice Address - Street 2:
Practice Address - City:REXBURG
Practice Address - State:ID
Practice Address - Zip Code:83440-1608
Practice Address - Country:US
Practice Address - Phone:208-359-1770
Practice Address - Fax:208-359-1780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-19
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health