| Organization Name: | BLUE MOUNTAIN HOSPITAL |
| NPI Number: | 1114152527 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JEREMY LYMAN (CEO) |
| Mailing Address: | 802 S 200 W Suite A Blanding |
| State: | UT US |
| Postal Code: | 84511 |
| Phone Number: | 4356783993 |
| Fax Number: | 4356783992 |
| NPI Enumeration Date: | 05/29/2009 |
| NPI Last Update Date: | 05/12/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
| Taxonomy Definition: | |