| Organization Name: | CENTRAL VALLEY MEDICAL CENTER |
| NPI Number: | 1568486918 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHAUNA ARCHIBALD (EXECUTIVE DIRECTOR) |
| Mailing Address: | 152 W 1500 N Suite A Nephi |
| State: | UT US |
| Postal Code: | 846489999 |
| Phone Number: | 4356233060 |
| Fax Number: | 4356233059 |
| NPI Enumeration Date: | 07/27/2006 |
| NPI Last Update Date: | 03/15/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BX2000X |
| License Number: | 1184990001 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Oxygen Equipment & Supplies |
| Taxonomy Definition: | |