| Pure Healthcare Of Utah, Llc | |
|
4179 S Riverboat Rd Ste 170 Taylorsville UT 84123-2702 | |
| (385) 276-3945 | |
| (801) 852-0999 |
| Full Name | Pure Healthcare Of Utah, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4179 S Riverboat Rd Ste 170, Taylorsville, Utah |
| Authorized Official Name and Position | Rachel Fraga (CONTRACTING MANAGER) |
| Authorized Official Contact | 8019216325 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pure Healthcare Of Utah, Llc 4179 S Riverboat Rd Ste 220 Taylorsville UT 84123-2986 Ph: (801) 755-3387 | Pure Healthcare Of Utah, Llc 4179 S Riverboat Rd Ste 170 Taylorsville UT 84123-2702 Ph: (385) 276-3945 |
| NPI Number | 1831782994 |
|---|---|
| Provider Enumeration Date | 02/18/2021 |
| Last Update Date | 03/17/2023 |
| Medicare PECOS PAC ID | 8921400458 |
|---|---|
| Medicare Enrollment ID | O20210707000907 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831782994 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | John E Storheim |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1699744367 PECOS PAC ID: 3375574536 Enrollment ID: I20061101000242 |
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