MEDICARE: UINTAH BASIN MEDICAL CENTER

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	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	2005-HOSP-180	UT
2	335E00000X	Prosthetic/Orthotic Supplier	2005-HOSP-	UT
3	332B00000X	Durable Medical Equipment & Medical Supplies	2005-HOSP-180	UT
4	332BX2000X	Oxygen Equipment & Supplies (DME)	2005-HOSP-180	UT
5	332BX2000X	Oxygen Equipment & Supplies (DME)	2011-HOSP-180	UT

General Provider Information

NPI Number	:	1851357511
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UINTAH BASIN MEDICAL CENTER

Provider Business Mailing Address
First Line	:	250 W 300 N
Second Line	:
City	:	ROOSEVELT
State	:	UT
Zip	:	84066-2336
Country	:	US
Telephone Number	:	435-725-7448
Fax Number	:	435-722-9291

Provider Business Practice Location Address
First Line	:	26 WEST 200 NORTH
Second Line	:
City	:	ROOSEVELT
State	:	UT
Zip	:	84066-2329
Country	:	US
Telephone Number	:	435-722-2418
Fax Number	:	435-722-6187

Authorized Official
Title or Position	:	CEO
Name	:	MR. JAMES MARSHALL
Credential	:
Telephone Number	:	435-722-4691

Provider Enumeration Date	:	04/21/2006
Last Update Date	:	10/22/2025

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Directions to “UINTAH BASIN MEDICAL CENTER ” Practice Location

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