MEDICARE: HEALTHTRUST UTAH MGMT SERVICES, INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	1041C0700X	Clinical Social Worker
2	133V00000X	Registered Dietitian
3	207RC0200X	Critical Care Medicine (Internal Medicine) Physician
4	207RP1001X	Pulmonary Disease Physician
5	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1710273297
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHTRUST UTAH MGMT SERVICES, INC

Provider Business Mailing Address
First Line	:	PO BOX 271220
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84127-1220
Country	:	US
Telephone Number	:	801-736-0720
Fax Number	:	801-366-9883

Provider Business Practice Location Address
First Line	:	6985 UNION PARK CTR
Second Line	:	STE 500
City	:	COTTONWOOD HEIGHTS
State	:	UT
Zip	:	84047-4177
Country	:	US
Telephone Number	:	801-568-5977
Fax Number	:

Authorized Official
Title or Position	:	DIVISION CONTROLLER
Name	:	JODY DIAL
Credential	:
Telephone Number	:	801-568-5977

Provider Enumeration Date	:	06/23/2011
Last Update Date	:	06/23/2011

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