| Intermountain Health Lds Hospital | |
|
8th Avenue And C St Salt Lake City UT 84143-0001 | |
| (801) 408-1100 | |
| Not Available |
| Full Name | Intermountain Health Lds Hospital |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 8th Avenue And C St, Salt Lake City, Utah |
| Authorized Official Name and Position | Denis Smith (CFO) |
| Authorized Official Contact | 8014422000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Intermountain Health Lds Hospital Po Box 30180 Salt Lake City UT 84130-0180 Ph: () - | Intermountain Health Lds Hospital 8th Avenue And C St Salt Lake City UT 84143-0001 Ph: (801) 408-1100 |
| NPI Number | 1528078581 |
|---|---|
| Provider Enumeration Date | 08/09/2006 |
| Last Update Date | 09/16/2024 |
| Certification Date | 09/16/2024 |
| Medicare PECOS PAC ID | 1850209420 |
|---|---|
| Medicare Enrollment ID | O20050628000647 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528078581 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 2007-12-BH (Utah) | Secondary |
| 282N00000X | General Acute Care Hospital | 2005-HOSP-174 (Utah) | Primary |
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