MEDICARE: UT MEDICAL SUPPLY 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	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1619847613
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UT MEDICAL SUPPLY LLC

Provider Business Mailing Address
First Line	:	3108 AVENUE APT A
Second Line	:	APT A
City	:	FORT PIERCE
State	:	FL
Zip	:	34947
Country	:	US
Telephone Number	:	561-779-9039
Fax Number	:

Provider Business Practice Location Address
First Line	:	4455 S 700 E STE 200
Second Line	:
City	:	MILLCREEK
State	:	UT
Zip	:	84107-3153
Country	:	US
Telephone Number	:	561-779-9039
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MISS MARGARET FRANCOIS I
Credential	:
Telephone Number	:	561-779-9039

Provider Enumeration Date	:	11/06/2025
Last Update Date	:	11/06/2025

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Directions to “UT MEDICAL SUPPLY LLC ” Practice Location

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