NPIMap

Organization Active NPI

Tooele Mobile Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Tooele, UT
National Provider Identifier
1174833057
Registry record updated Oct 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
2010216 Issued in UT
Legal business name
TOOELE MOBILE DIALYSIS LLC
Practice address
1298 E 850 N
Tooele, UT 84074-8914
Phone
(801) 867-7464
Fax
(801) 606-2950
NPI assigned
Oct 13, 2010
Last updated
Oct 13, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Hodson Jean
Title
Ceo
Phone
(801) 867-7464

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 2010216 UT Primary

Addresses

Primary practice location

1298 E 850 N
Tooele, UT 84074-8914

Mailing address

1298 E 850 N
Tooele, UT 84074-8914
Phone (801) 867-7464

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1286928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286928000000",
    "number": "1174833057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1298 E 850 N",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840748914",
            "telephone_number": "801-867-7464",
            "fax_number": "801-606-2950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1298 E 850 N",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840748914",
            "telephone_number": "801-867-7464",
            "fax_number": "801-606-2950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOOELE MOBILE DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-13",
        "last_updated": "2010-10-13",
        "status": "A",
        "authorized_official_last_name": "JEAN",
        "authorized_official_first_name": "HODSON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "801-867-7464"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "UT",
            "license": "2010216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tooele, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; 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.