ACQUA MEDICAL LLC NPI 1427580448

NPI Information

  • NPI: 1427580448
  • Provider Name: ACQUA MEDICAL LLC
  • Classification: Family Medicine - 207QA0401X
  • Specialization: Addiction Medicine
  • Entity Type: Organization
  • Address: 100 N JOHNSON MILL RD
    MIDWAY, UT
    ZIP 84049
  • Phone: (844) 654-3700

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NPI Details

ACQUA MEDICAL LLC is an addiction medicine family medicine in Midway, UT. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. ACQUA MEDICAL LLC NPI is 1427580448. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

100 N JOHNSON MILL RD
MIDWAY, UT
ZIP 84049-764
Phone: (844) 654-3700
Fax: (801) 926-1133

The provider's authorized official is Clint Tolman .
The authorized official title is Administrative Director and has the following contact phone number (844) 654-3700.

The enumeration date for this NPI number is 3/29/2017 and was last updated on 6/20/2018.

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
12084A0401XPsychiatry & NeurologyAddiction MedicineNo
2207QA0401XFamily MedicineAddiction Medicine293281-1205UTAHYes

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=========OTHERUTAHEIN

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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