Organization Active NPI

Scooter Store - Salt Lake City LLC

  • Durable Medical Equipment & Medical Supplies
  • Murray, UT
National Provider Identifier
1104848100
Registry record updated Aug 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
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.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 9, 2013

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
118422900MedicaidWY
1104848100MedicaidID
1104848100MedicaidNV

Other names 1

  • The SCOOTER Store/Alliance Seating & Mobility Doing business as

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.