Provo Dialysis Center University of Utah

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

License

2004-ESRD-228 Issued in UT

Legal business name

PROVO DIALYSIS CENTER UNIVERSITY OF UTAH

Doing business as

University of Utah

Practice address

1675 N Freedom Blvd
Provo, UT 84604-2540

Phone

(801) 373-0167

Fax

(801) 374-1989

NPI assigned

Sep 22, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Steven L Hemming

Title

Program Administrator

Phone

(801) 581-8573

Specialties & licenses 1

Addresses

Other names 1

• University of Utah Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• University of Utah

  dba University of Utah Home Infusion Pharmacy

  • Home Infusion Therapy Pharmacy
  • Murray, UT
  • NPI 1306883954

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400630400000",
    "number": "1194824201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27071",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270071",
            "telephone_number": "801-581-8578",
            "fax_number": "801-374-1989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 N FREEDOM BLVD",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846042540",
            "telephone_number": "801-373-0167",
            "fax_number": "801-374-1989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVO DIALYSIS CENTER UNIVERSITY OF UTAH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2014-05-21",
        "status": "A",
        "authorized_official_last_name": "HEMMING",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PROGRAM ADMINISTRATOR",
        "authorized_official_telephone_number": "801-581-8573",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "UT",
            "license": "2004-ESRD-228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University of Utah",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Provo City Corporation (Provo City Fire/Ambulance)
• Provo City School District
• Provo Counseling Center
• Provo Counseling Center
• Provo Dental Care LLC (Stonehaven Dental - Provo, LLC)
• Provo Downtown Dental, LLC (Provo Downtown Dental)
• Provo Family Dentistry, LLC (The Dental Edge)
• Provo House of Hope
• Provo Orem Family & Cosmetic Dentistry PLLC
• Provo PDC PLLC (Platinum Dental Care)

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Provo, UT
• Providers in Provo, UT by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2014; 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.