Healthcare Provider Details

I. General information

NPI: 1568494060
Provider Name (Legal Business Name): VA HEALTH CARE SYSTEM, SALT LAKE CITY, UT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 FOOTHILL BLVD
SALT LAKE CITY UT
84148-0001
US

IV. Provider business mailing address

4324 GARDEN DR
SALT LAKE CITY UT
84124-2406
US

V. Phone/Fax

Practice location:
  • Phone: 801-582-1565
  • Fax: 801-584-1297
Mailing address:
  • Phone: 801-263-3563
  • Fax: 801-263-3563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number5678120-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number5678120-1205
License Number StateUT

VIII. Authorized Official

Name: DR. ASHIT BARAN SARKER
Title or Position: PATHOLOGIST
Credential:
Phone: 801-582-1565