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GRANGER MEDICAL SPECIALISTS LLC NPI 1376159368


NPI Information

NPI: 1376159368
Provider Name: GRANGER MEDICAL SPECIALISTS LLC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 46D2120336

Address:
2965 W 3500 S
WEST VALLEY CITY, UT
ZIP 84119
Phone: (801) 965-3600
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GRANGER MEDICAL SPECIALISTS LLC is a clinic center in West Valley City, UT. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). GRANGER MEDICAL SPECIALISTS LLC NPI is 1376159368. The provider is registered as an organization entity type.

The provider's business location address is:

2965 W 3500 S
WEST VALLEY CITY, UT
ZIP 84119-602
Phone: (801) 965-3600

The provider's authorized official is Mary Jane Pennington .
The authorized official title is President/ceo and has the following contact phone number (801) 965-3600.

The CLIA number assigned to this NPI record is 46D2120336 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/16/2020 and was last updated on 9/16/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/CenterYes

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.