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
National Provider Directory
- Tax ID family
- Bradley S Thompson DO
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2013. 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.