Healthcare Provider Details

I. General information

NPI: 1407187701
Provider Name (Legal Business Name): MONITORING ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2010
Last Update Date: 07/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1817 W 800 N
SALT LAKE CITY UT
84025
US

IV. Provider business mailing address

8400 MENAUL BLVD. A211
ALBUQUERQUE NM
87112-2260
US

V. Phone/Fax

Practice location:
  • Phone: 505-836-7894
  • Fax: 888-315-4512
Mailing address:
  • Phone: 505-836-7894
  • Fax: 888-315-4512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. NICK C LUEKENGA
Title or Position: OWNER
Credential:
Phone: 801-920-1171