| Intermountian Lipid Center | |
|
421 S Wakara Way Ste 121 Salt Lake City UT 84108-1244 | |
| (801) 583-8852 | |
| (801) 581-6862 |
| Full Name | Intermountian Lipid Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 421 S Wakara Way Ste 121, Salt Lake City, Utah |
| Authorized Official Name and Position | Eliot Ashby Brinton (OWNER) |
| Authorized Official Contact | 8015816862 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Intermountian Lipid Center Po Box 268 Bountiful UT 84011-0268 Ph: (801) 296-2113 | Intermountian Lipid Center 421 S Wakara Way Ste 121 Salt Lake City UT 84108-1244 Ph: (801) 583-8852 |
| NPI Number | 1699043943 |
|---|---|
| Provider Enumeration Date | 12/01/2011 |
| Last Update Date | 02/06/2018 |
| Medicare PECOS PAC ID | 2769645217 |
|---|---|
| Medicare Enrollment ID | O20120518000566 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699043943 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 5353571-1205 (Utah) | Primary |
| Provider Name | Eliot A Brinton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033209614 PECOS PAC ID: 8921086372 Enrollment ID: I20040712000749 |
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