Active NPI
Scooter Store - Salt Lake City LLC
- Durable Medical Equipment & Medical Supplies
- Murray, UT
National Provider Identifier
1104848100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- SCOOTER STORE - SALT LAKE CITY LLC
- Practice address
- 4894 Commerce Dr Ste D
Murray, UT 84107-4787 - Phone
- (801) 281-0553
- NPI assigned
- Jul 25, 2006
- Organization subpart
- Yes
- Parent organization
- THE SCOOTER STORE - USA, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jason Cone
- Title
- General Counsel & Secretary
- Phone
- (830) 627-4433
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
4894 Commerce Dr Ste D
Murray, UT 84107-4787
Mailing address
PO Box 310709
New Braunfels, TX 78131-0709
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 118422900 | Medicaid | WY | |
| 1104848100 | Medicaid | ID | |
| 1104848100 | Medicaid | NV |
Other names 1
- The SCOOTER Store/Alliance Seating & Mobility
National Provider Directory
National Provider DirectoryLocations
4894 S Commerce Dr
Ste D
Murray, UT 84107
Phone (801) 281-0553
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1376006400000",
"number": "1104848100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 310709",
"city": "NEW BRAUNFELS",
"state": "TX",
"postal_code": "781310709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4894 COMMERCE DR STE D",
"city": "MURRAY",
"state": "UT",
"postal_code": "841074787",
"telephone_number": "801-281-0553"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SCOOTER STORE - SALT LAKE CITY LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "THE SCOOTER STORE - USA, INC.",
"enumeration_date": "2006-07-25",
"last_updated": "2013-08-09",
"status": "A",
"authorized_official_last_name": "CONE",
"authorized_official_first_name": "JASON",
"authorized_official_title_or_position": "GENERAL COUNSEL & SECRETARY",
"authorized_official_telephone_number": "830-627-4433"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "118422900",
"state": "WY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1104848100",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1104848100",
"state": "NV"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "The SCOOTER Store/Alliance Seating & Mobility",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Murray, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.