Healthcare Provider Details

I. General information

NPI: 1396018545
Provider Name (Legal Business Name): RED ROCK MEDICAL SUPPLY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2012
Last Update Date: 09/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1880 N 2200 W STE 40
SALT LAKE CITY UT
84116-4136
US

IV. Provider business mailing address

450 S 900 E STE 100
SALT LAKE CITY UT
84102-2981
US

V. Phone/Fax

Practice location:
  • Phone: 801-886-9700
  • Fax: 801-415-9423
Mailing address:
  • Phone: 801-886-9700
  • Fax: 801-531-1949

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: EDDIE NORRIS
Title or Position: OWNER
Credential:
Phone: 801-485-6166