Canyonlands Medical LC
Organization Active NPI Oxygen Equipment & Supplies (DME) · South Ogden, UT
NPI 1497734362 · NPPES record last updated Apr 20, 2008
Key facts
- NPI
- 1497734362
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Oxygen Equipment & Supplies (DME) 332BX2000X
- License
- 5528522-1703 (UT)
- Legal business name
- CANYONLANDS MEDICAL LC
- Practice address
- 5790 Harrison Blvd
Ste. 2
South Ogden, UT 84403-4325 - Phone
- (801) 393-6333
- Fax
- (801) 394-6333
- NPI assigned
- Jan 10, 2006
- Organization subpart
- No
Authorized official
- Name
- Dar Nelson
- Title
- Pres
- Phone
- (801) 393-6333
Corporate family (same tax ID) 2
National Provider Directory
- Tax ID family
- Canyonlands Medical LC
Locations
5790 Harrison Blvd
#2
South Ogden, UT 84403
Phone (801) 393-6333
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 5528522-1703 | UT | |
| Oxygen Equipment & Supplies (DME) | 332BX2000X | 5528522-1703 | UT | Yes |
Addresses
Primary practice location
5790 Harrison Blvd
Ste. 2
South Ogden, UT 84403-4325
Mailing address
PO Box 150193
Ogden, UT 84415-0193
Phone (801) 393-6333
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 870479372003 | Medicaid | UT |
Other providers in South Ogden, UT
- Jamie Call
- Karynn Camp
- Jason D Campbell
- Canyon Ogden Home Health LLC
- Canyon Ogden Hospice LLC
- Canyonlands Medical LC
- Carbajal Kids, LLC
- L Scott Cardon
- Kristen Carpenter
- Brittany Case
All providers in South Ogden, UT · Oxygen Equipment & Supplies (DME) in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.