Active NPI
Specialty Sales & Service a Utah Business Trust
- Parenteral & Enteral Nutrition Supplies (DME)
- Logan, UT
National Provider Identifier
1396804753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Parenteral & Enteral Nutrition Supplies (DME)
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180111000743 | UT | DME Supplier - Medical Supply Company | 2860751229 | Practice locations: Logan, UT |
National Provider Directory
National Provider Directory- Tax ID family
- Specialty Sales Service
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Durable Medical Equipment & Medical Supplies
- Logan, UT
- NPI 1114850997
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.