Organization Active NPI

Specialty Sales & Service a Utah Business Trust

  • Parenteral & Enteral Nutrition Supplies (DME)
  • Logan, UT
National Provider Identifier
1396804753
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Parenteral & Enteral Nutrition Supplies (DME)Taxonomy code 332BP3500X
Legal business name
SPECIALTY SALES & SERVICE A UTAH BUSINESS TRUST
Practice address
580 N Main St Ste 250D
Logan, UT 84321-2537
Phone
(801) 679-1874
Fax
(801) 679-1875
NPI assigned
Dec 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Authorized official

Name
Mr. Michael Zeller
Title
Authorized Agent
Phone
(801) 679-1874

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X Primary

Addresses

Primary practice location

580 N Main St Ste 250D
Logan, UT 84321-2537

Mailing address

580 N Main St Ste 250D
Logan, UT 84321-2537
Phone (801) 850-1874

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180111000743 UT DME Supplier - Medical Supply Company 2860751229 Practice locations: Logan, UT

National Provider Directory

National Provider Directory
Tax ID family
Specialty Sales Service2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790035200000",
    "number": "1396804753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 N MAIN ST STE 250D",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843212537",
            "telephone_number": "801-850-1874",
            "fax_number": "801-679-1875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 N MAIN ST STE 250D",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843212537",
            "telephone_number": "801-679-1874",
            "fax_number": "801-679-1875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY SALES & SERVICE A UTAH BUSINESS TRUST",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A",
        "authorized_official_last_name": "ZELLER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "AUTHORIZED AGENT",
        "authorized_official_telephone_number": "801-679-1874",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.