FAMILY SURGICAL SUITE NPI 1508040221

NPI Information

NPI: 1508040221
Provider Name: FAMILY SURGICAL SUITE
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 46D1102181

Address:
8822 S REDWOOD RD
SUITE 113
WEST JORDAN, UT
ZIP 84088
Phone: (801) 495-1064
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FAMILY SURGICAL SUITE is an ambulatory surgical clinic center in West Jordan, UT. FAMILY SURGICAL SUITE NPI is 1508040221. The provider is registered as an organization entity type.

The provider's business location address is:

8822 S REDWOOD RD
SUITE 113
WEST JORDAN, UT
ZIP 84088-336
Phone: (801) 495-1064
Fax: (801) 523-1139

The provider's authorized official is Brian Jan Dehart .
The authorized official title is Managing Member and has the following contact phone number (801) 495-1064.

The CLIA number assigned to this NPI record is 46D1102181 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/18/2007 and was last updated on 12/18/2007.

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	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

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

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