| Intermountain At Home | |
|
11520 S Redwood Rd South Jordan UT 84095-7805 | |
| (385) 887-7300 | |
| Not Available |
| Full Name | Intermountain At Home |
|---|---|
| Speciality | Clinic/center |
| Location | 11520 S Redwood Rd, South Jordan, Utah |
| Authorized Official Name and Position | Mark Briesacher (CLINICAL INTEGRATION SR VP) |
| Authorized Official Contact | 8014423495 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Intermountain At Home Po Box 27128 Salt Lake City UT 84127-0128 Ph: (385) 887-7300 | Intermountain At Home 11520 S Redwood Rd South Jordan UT 84095-7805 Ph: (385) 887-7300 |
| NPI Number | 1669736278 |
|---|---|
| Provider Enumeration Date | 06/28/2012 |
| Last Update Date | 02/24/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669736278 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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