Healthcare Provider Details

I. General information

NPI: 1720574130
Provider Name (Legal Business Name): DIATHRIVE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2018
Last Update Date: 11/01/2022
Certification Date: 11/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5120 W AMELIA EARHART DR
SALT LAKE CITY UT
84116-2854
US

IV. Provider business mailing address

5120 W AMELIA EARHART DR
SALT LAKE CITY UT
84116-2854
US

V. Phone/Fax

Practice location:
  • Phone: 866-878-7477
  • Fax:
Mailing address:
  • Phone: 866-878-7477
  • Fax:

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: CHRIS SEEGMILLER
Title or Position: COO
Credential:
Phone: 801-894-9816