NPIMap

Organization Active NPI

Canyonlands Medical LC

  • Oxygen Equipment & Supplies (DME)
  • South Ogden, UT
National Provider Identifier
1689846289
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
License
5528522-1703 Issued in 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
Mar 24, 2008
Last updated
Mar 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

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

Authorized official

Name
Dar Nelson
Title
Pres.
Phone
(801) 393-6333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oxygen Equipment & Supplies (DME) 332BX2000X 5528522-1703 UT Primary

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 2

IdentifierTypeStateIssuer
5528522-1703OtherUTPHARMACY
4954590001OtherUTMEDICARE SUPPLIER

National Provider Directory

National Provider Directory
Tax ID family
Canyonlands Medical LC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1206316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1689846289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 150193",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844150193",
            "telephone_number": "801-393-6333",
            "fax_number": "801-394-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5790 HARRISON BLVD",
            "address_2": "STE. 2",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844034325",
            "telephone_number": "801-393-6333",
            "fax_number": "801-394-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANYONLANDS MEDICAL LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-24",
        "last_updated": "2008-03-24",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "DAR",
        "authorized_official_title_or_position": "PRES.",
        "authorized_official_telephone_number": "801-393-6333"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "UT",
            "license": "5528522-1703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY",
            "identifier": "5528522-1703",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SUPPLIER",
            "identifier": "4954590001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; 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.