Healthcare Provider Details

I. General information

NPI: 1235715996
Provider Name (Legal Business Name): CENTRAL UTAH SURGICENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 07/14/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 WEST 800 NORTH
OREM UT
84057
US

IV. Provider business mailing address

640 WEST 800 NORTH
OREM UT
84057
US

V. Phone/Fax

Practice location:
  • Phone: 801-374-0354
  • Fax: 801-717-2364
Mailing address:
  • Phone: 801-374-0354
  • Fax: 801-717-2364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name: WILLIAM G SWINNEY
Title or Position: VP
Credential:
Phone: 972-789-2877