MEDICARE: DURAMED LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1255704060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DURAMED LLC

Provider Business Mailing Address
First Line	:	2164 S RICHARDS ST
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84115-2606
Country	:	US
Telephone Number	:	888-512-5256
Fax Number	:	888-522-0355

Provider Business Practice Location Address
First Line	:	2164 S RICHARDS ST
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84115-2606
Country	:	US
Telephone Number	:	888-512-5256
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DARIN WILLIAM JOHNCOCK
Credential	:
Telephone Number	:	888-412-8087

Provider Enumeration Date	:	11/03/2015
Last Update Date	:	08/26/2021

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Directions to “DURAMED LLC ” Practice Location

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