Healthcare Provider Details

I. General information

NPI: 1144259805
Provider Name (Legal Business Name): COUNTY OF SUMMIT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 04/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 EAST 400 SOUTH
KAMAS UT
84036-0266
US

IV. Provider business mailing address

PO BOX 95970
SOUTH JORDAN UT
84095-0970
US

V. Phone/Fax

Practice location:
  • Phone: 435-783-6276
  • Fax: 435-783-6277
Mailing address:
  • Phone: 801-352-9500
  • Fax: 801-352-9502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BLAKE L FRAZIER
Title or Position: AUDITOR
Credential:
Phone: 435-336-3254