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General NPI Number Information
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NPI Number | 1174465488
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Entity Type | Organization
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Legal Business Name | NORTHERN UTAH HEALTHCARE CORPORATION
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Dates
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Enumeration Date | 04/07/2026
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Last Update Date | 04/07/2026
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Provider Practice Location Address
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Address Line | 5668 BRUD DR
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City | WEST VALLEY
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State | UT
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Zip | 84128-6909
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Country | US
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Telephone | 615-344-9551
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Fax |
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Provider Business Mailing Address
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Address Line | 5668 BRUD DR
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City | WEST VALLEY
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State | UT
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Zip | 84128-6909
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MATTHEW STEVEN HASBROUCK
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Credential |
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Telephone | 615-792-6123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number |
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License Number State |
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