Healthcare Provider Details

I. General information

NPI: 1689605842
Provider Name (Legal Business Name): PRAXAIR HEALTHCARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 04/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1509 S 270 E SUITE 9
ST GEORGE UT
84790-2297
US

IV. Provider business mailing address

203 E 6100 S
SALT LAKE CITY UT
84107-7302
US

V. Phone/Fax

Practice location:
  • Phone: 435-673-3250
  • Fax: 409-654-2068
Mailing address:
  • Phone: 801-261-7139
  • Fax: 801-288-5906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier100500837
Identifier TypeMEDICAID
Identifier StateNV
Identifier Issuer
# 2
Identifier1689605842
Identifier TypeMEDICAID
Identifier StateUT
Identifier Issuer

VIII. Authorized Official

Name: SCOTT KALTRIDER
Title or Position: PRESIDENT
Credential:
Phone: 203-837-2330