BESSA INC NPI 1598871337

NPI Information

NPI: 1598871337
Provider Name: BESSA, INC

Doing Business As: UINTAH BASIN DIALYSIS CENTER

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
384 NORTH 100 WEST #74-6
ROOSEVELT, UT
ZIP 84066
Phone: (435) 722-5056
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BESSA, INC is an end-stage renal disease (esrd) treatment clinic center in Roosevelt, UT. BESSA, INC NPI is 1598871337. The provider is registered as an organization entity type.
The provider Is Doing Business As Uintah Basin Dialysis Center.

The provider's business location address is:

384 NORTH 100 WEST #74-6
ROOSEVELT, UT
ZIP 84066
Phone: (435) 722-5056
Fax: (435) 722-0779

The provider's authorized official is Edwin C Bulloch .
The authorized official title is Administrator and has the following contact phone number (435) 722-5056.

The enumeration date for this NPI number is 8/22/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment	2005-ESRD-229	UTAH	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	87035602601001	OTHER	UTAH	BLUE CROSS BLUE SHIELD PR
2	870356026005	MEDICAID	UTAH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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