Healthcare Provider Details

I. General information

NPI: 1922031533
Provider Name (Legal Business Name): UTE INDIAN TRIBE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 07/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EAST HIGHWAY 40
FT DUSCHESNE UT
84026
US

IV. Provider business mailing address

PO BOX 876
PRICE UT
84501-0876
US

V. Phone/Fax

Practice location:
  • Phone: 435-572-2228
  • Fax:
Mailing address:
  • Phone: 888-834-5032
  • Fax: 435-613-9414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: BEVERLY J BURT
Title or Position: EMS DIRECTOR
Credential: EMTI
Phone: 435-722-2286