Healthcare Provider Details

I. General information

NPI: 1053574095
Provider Name (Legal Business Name): ACTION MEDICAL MOBILITY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 07/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4035 S 300 W
SALT LAKE CITY UT
84107-1400
US

IV. Provider business mailing address

4035 S 300 W
SALT LAKE CITY UT
84107-1400
US

V. Phone/Fax

Practice location:
  • Phone: 801-263-3180
  • Fax: 801-263-3720
Mailing address:
  • Phone: 801-263-3180
  • Fax: 801-263-3720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MIKE S. MCDONOUGH
Title or Position: CEO/OWNER
Credential:
Phone: 801-263-3180