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100 N Mario Capecchi Dr Salt Lake City UT 84113-1103 | |
| (801) 662-1000 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 100 N Mario Capecchi Dr, Salt Lake City, Utah |
| Authorized Official Name and Position | Sidney Norton (FINANCE AVP-PEDIATRICS) |
| Authorized Official Contact | 8014422000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 30180 Salt Lake City UT 84130-0180 Ph: () - | 100 N Mario Capecchi Dr Salt Lake City UT 84113-1103 Ph: (801) 662-1000 |
| NPI Number | 1235148594 |
|---|---|
| Provider Enumeration Date | 08/05/2006 |
| Last Update Date | 09/16/2024 |
| Certification Date | 09/16/2024 |
| Medicare PECOS PAC ID | 1850209420 |
|---|---|
| Medicare Enrollment ID | O20050712001244 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235148594 | NPI | - | NPPES |
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