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50 N Medical Dr Salt Lake City UT 84132-0100 | |
| (801) 581-2121 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 50 N Medical Dr, Salt Lake City, Utah |
| Authorized Official Name and Position | Charlton Park (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 8015851325 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 511258 Los Angeles CA 90051-7813 Ph: (801) 587-6760 | 50 N Medical Dr Salt Lake City UT 84132-0100 Ph: (801) 581-2121 |
| NPI Number | 1588656870 |
|---|---|
| Provider Enumeration Date | 08/22/2005 |
| Last Update Date | 08/16/2023 |
| Medicare PECOS PAC ID | 0749262665 |
|---|---|
| Medicare Enrollment ID | O20040603001508 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588656870 | NPI | - | NPPES |
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