Healthcare Provider Details
I. General information
NPI: 1760312953
Provider Name (Legal Business Name): IROCK MED SUPPLIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1014 N 1300 W
PLEASANT GROVE UT
84062-9463
US
IV. Provider business mailing address
1014 N 1300 W
PLEASANT GROVE UT
84062-9463
US
V. Phone/Fax
- Phone: 914-577-1352
- Fax:
- Phone:
- Fax:
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 | |
VIII. Authorized Official
Name:
IZAK
ROCK
Title or Position: CEO
Credential:
Phone: 914-577-1352