Healthcare Provider Details

I. General information

NPI: 1639093131
Provider Name (Legal Business Name): WHITE CARD MEDICAL SUPPLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6268 S 900 E
MURRAY UT
84121-2497
US

IV. Provider business mailing address

6268 S 900 E STE D
MURRAY UT
84121-2497
US

V. Phone/Fax

Practice location:
  • Phone: 801-419-2413
  • Fax:
Mailing address:
  • Phone: 801-419-2413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: PAUL WEIMER
Title or Position: MEMBER
Credential:
Phone: 801-419-2413