Healthcare Provider Details

I. General information

NPI: 1497191001
Provider Name (Legal Business Name): PULMONARY HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2013
Last Update Date: 08/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2307 N HILL FIELD RD STE 102
LAYTON UT
84041-6890
US

IV. Provider business mailing address

4885 S 900 E STE 107
SALT LAKE CITY UT
84117-3905
US

V. Phone/Fax

Practice location:
  • Phone: 801-266-0399
  • Fax: 801-266-0421
Mailing address:
  • Phone: 801-266-0399
  • Fax: 801-266-0421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number6209500-5701
License Number StateUT

VIII. Authorized Official

Name: MISS MARY CANNON
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 801-266-0399