Healthcare Provider Details

I. General information

NPI: 1710273297
Provider Name (Legal Business Name): HEALTHTRUST UTAH MGMT SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2011
Last Update Date: 06/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6985 UNION PARK CTR STE 500
COTTONWOOD HEIGHTS UT
84047-4177
US

IV. Provider business mailing address

PO BOX 271220
SALT LAKE CITY UT
84127-1220
US

V. Phone/Fax

Practice location:
  • Phone: 801-568-5977
  • Fax:
Mailing address:
  • Phone: 801-736-0720
  • Fax: 801-366-9883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JODY DIAL
Title or Position: DIVISION CONTROLLER
Credential:
Phone: 801-568-5977