Healthcare Provider Details

I. General information

NPI: 1013757483
Provider Name (Legal Business Name): IVEE MOBILE HYDRATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2024
Last Update Date: 05/31/2024
Certification Date: 05/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 S 770 E
SPANISH FORK UT
84660-2488
US

IV. Provider business mailing address

903 S 770 E
SPANISH FORK UT
84660-2488
US

V. Phone/Fax

Practice location:
  • Phone: 801-592-2539
  • Fax:
Mailing address:
  • Phone: 801-592-2539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TANGI PERRY
Title or Position: CO-OWNER
Credential: BSN
Phone: 801-592-2539