Healthcare Provider Details

I. General information

NPI: 1487734976
Provider Name (Legal Business Name): UNIVERSITY OF UTAH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S CHIPETA WAY
SALT LAKE CITY UT
84108-1222
US

IV. Provider business mailing address

PO BOX 511258
LOS ANGELES CA
90051-7813
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-2353
  • Fax: 801-585-6363
Mailing address:
  • Phone: 801-583-2500
  • Fax: 801-585-6363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLTON PARK
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 801-585-1325