Healthcare Provider Details

I. General information

NPI: 1538045182
Provider Name (Legal Business Name): WHITE SANDS MEDICAL SUPPLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4262 W 4000 N
CEDAR CITY UT
84721-5227
US

IV. Provider business mailing address

4262 W 4000 N
CEDAR CITY UT
84721-5227
US

V. Phone/Fax

Practice location:
  • Phone: 801-376-2045
  • Fax:
Mailing address:
  • Phone: 801-376-2045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: AARON COLLETTE
Title or Position: OWNER
Credential:
Phone: 801-376-2045