INTERMOUNTAIN PEDIATRIC DIALYSIS NPI 1235238379

NPI Information

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:

Other Identifiers

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

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