Intermountain Healthcare

Organization Active NPI Health Maintenance Organization · Salt Lake City, UT

NPI 1760810337 · NPPES record last updated Oct 17, 2013

Key facts

NPI
1760810337
Entity type
Organization (NPI type 2)
Primary specialty
Health Maintenance Organization 302R00000X
License
932611213501 (UT)
Legal business name
INTERMOUNTAIN HEALTHCARE
Practice address
324 E 10TH Ave Ste 178
Salt Lake City, UT 84103-2885
Phone
(801) 408-8500
NPI assigned
Oct 17, 2013
Organization subpart
No

Authorized official

Name
Gudrun Ulrike Mirin, LCSW
Title
Clinical Social Worker
Phone
(801) 408-8500

Corporate family (same tax ID) 24

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

National Provider Directory

Tax ID family
Bradley S Thompson DO (479 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 932611213501 UT Yes

Addresses

Primary practice location

324 E 10TH Ave Ste 178
Salt Lake City, UT 84103-2885

Mailing address

324 E 10TH Ave Ste 178
Salt Lake City, UT 84103-2885

Other providers in Salt Lake City, UT

All providers in Salt Lake City, UT · Health Maintenance Organization in Utah

Sources for this page

Verify at the official NPI Registry.