Healthcare Provider Details

I. General information

NPI: 1912936865
Provider Name (Legal Business Name): REHAB MEDICAL OF SALT LAKE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4750 W WILEY POST WAY STE 110
SALT LAKE CITY UT
84116-2807
US

IV. Provider business mailing address

3750 PRIORITY WAY SOUTH DR
INDIANAPOLIS IN
46240-3831
US

V. Phone/Fax

Practice location:
  • Phone: 801-904-3627
  • Fax:
Mailing address:
  • Phone: 317-436-6178
  • Fax: 855-671-9194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number000214
License Number StateUT

VIII. Authorized Official

Name: MR. PATRICK MCGINLEY
Title or Position: PRESIDENT
Credential:
Phone: 317-813-0205