Healthcare Provider Details

I. General information

NPI: 1972879609
Provider Name (Legal Business Name): NORTHERN UTAH HEALTHCARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2012
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E 3900 S
SALT LAKE CITY UT
84124-1300
US

IV. Provider business mailing address

1200 E 3900 S
SALT LAKE CITY UT
84124-1300
US

V. Phone/Fax

Practice location:
  • Phone: 801-268-7700
  • Fax: 801-270-3489
Mailing address:
  • Phone: 801-268-7700
  • Fax: 801-270-3489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL L. HERRON
Title or Position: CFO
Credential:
Phone: 801-268-7092