Healthcare Provider Details

I. General information

NPI: 1881578722
Provider Name (Legal Business Name): SALT LAKE SPECIALTY HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4252 S BIRKHILL BLVD
MURRAY UT
84107-5715
US

IV. Provider business mailing address

4252 S BIRKHILL BLVD
MURRAY UT
84107-5715
US

V. Phone/Fax

Practice location:
  • Phone: 707-503-8772
  • Fax:
Mailing address:
  • Phone: 707-503-8772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: MANPREET SINGH
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 707-503-8772