Provider Demographics
NPI:1245282227
Name:BRIGHAM CITY COMMUNITY HOSPITAL, INC.
Entity type:Organization
Organization Name:BRIGHAM CITY COMMUNITY HOSPITAL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SPUHLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-734-4200
Mailing Address - Street 1:950 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:BRIGHAM CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84302-4724
Mailing Address - Country:US
Mailing Address - Phone:435-734-4203
Mailing Address - Fax:435-423-5085
Practice Address - Street 1:950 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:BRIGHAM CITY
Practice Address - State:UT
Practice Address - Zip Code:84302-4724
Practice Address - Country:US
Practice Address - Phone:435-734-4203
Practice Address - Fax:435-423-5085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA3010014Medicaid
ID002990700Medicaid
ID002990700Medicaid
UT=========26001OtherBLUE CROSS
=========843020002OtherTRICARE
UT=========007Medicaid