Wasatch Infusion Services, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

149384-1205 Issued in UT

Legal business name

WASATCH INFUSION SERVICES, INC.

Practice address

348 E 4500 S
Suite 220
Salt Lake City, UT 84107-3906

Phone

(801) 577-7055

Fax

(888) 717-7578

NPI assigned

Oct 24, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Edwin Charles Schadewald III

Title

Ceo

Phone

(801) 739-5834

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414108800000",
    "number": "1205231859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 E 4500 S",
            "address_2": "SUITE 220",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841073906",
            "telephone_number": "801-577-7055",
            "fax_number": "888-717-7578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 E 4500 S",
            "address_2": "SUITE 220",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841073906",
            "telephone_number": "801-577-7055",
            "fax_number": "888-717-7578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASATCH INFUSION SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-24",
        "last_updated": "2014-10-24",
        "status": "A",
        "authorized_official_last_name": "SCHADEWALD",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "801-739-5834",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "UT",
            "license": "149384-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "U000074943",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Specialist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.