Healthcare Provider Details

I. General information

NPI: 1528221561
Provider Name (Legal Business Name): MURRAY CITY CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 03/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 E 4800 S
MURRAY UT
84107-3762
US

IV. Provider business mailing address

40 E 4800 S
MURRAY UT
84107-3762
US

V. Phone/Fax

Practice location:
  • Phone: 801-264-2781
  • Fax: 801-264-2787
Mailing address:
  • Phone: 801-264-2781
  • Fax: 801-264-2787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1868L
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. MIKE THOMAS DYKMAN
Title or Position: BATTALION CHIEF - EMS
Credential:
Phone: 801-264-2786