Healthcare Provider Details
I. General information
NPI: 1912814690
Provider Name (Legal Business Name): ACE MEDICAL PATIENT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
29 W COTTAGE AVE
SANDY UT
84070-1474
US
IV. Provider business mailing address
29 W COTTAGE AVE
SANDY UT
84070-1474
US
V. Phone/Fax
- Phone: 801-518-2646
- Fax: 385-324-6610
- Phone: 801-518-2646
- Fax: 385-324-6610
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NICOLE
SHANTEL
HICKMAN
Title or Position: OWNER
Credential: HICKMAN
Phone: 801-518-2646