INTERMOUNTAIN PEDIATRIC DIALYSIS NPI 1235238379

NPI Information

NPI: 1235238379
Provider Name: INTERMOUNTAIN PEDIATRIC DIALYSIS
Classification: Clinic/Center - 261QE0700X
Specialization: End-Stage Renal Disease (ESRD) Treatment
Entity Type: Organization
Doing Business As: UNIVERSITY OF UTAH
CLIA Number: 46D2039588
Address: 50 N MEDICAL DR
PA 220
SALT LAKE CITY, UT
ZIP 84132
Phone: (801) 581-4561

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NPI Details

INTERMOUNTAIN PEDIATRIC DIALYSIS is an end-stage renal disease (esrd) treatment clinic center in Salt Lake City, UT. INTERMOUNTAIN PEDIATRIC DIALYSIS NPI is 1235238379. The provider is registered as an organization entity type.
The provider Is Doing Business As University Of Utah.

The provider's business location address is:

50 N MEDICAL DR
PA 220
SALT LAKE CITY, UT
ZIP 84132-001
Phone: (801) 581-4561

The provider's authorized official is Steven L Hemming .
The authorized official title is Program Administrator and has the following contact phone number (801) 581-8573.

The CLIA number assigned to this NPI record is 46D2039588 - other - research with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/22/2006 and was last updated on 1/23/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment	2006-HOSP-208	UTAH	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	462300	MEDICARE ID-TYPE UNSPECIFIED	UTAH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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