Healthcare Provider Details
I. General information
NPI: 1548278427
Provider Name (Legal Business Name): KENSINGTON SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/04/2006
Last Update Date: 09/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
418 S 1400 W
OREM UT
84058-5896
US
IV. Provider business mailing address
418 S 1400 W
OREM UT
84058-5896
US
V. Phone/Fax
- Phone: 801-434-7411
- Fax: 801-224-4246
- Phone: 801-434-7411
- Fax: 801-224-4246
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| 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:
IAN
M
DAWE
Title or Position: CHIEF OPERATING OFFICER
Credential: R.N.
Phone: 801-224-5600