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General NPI Number Information
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NPI Number | 1225285299
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Entity Type | Organization
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Legal Business Name | RIVERDALE CITY UTAH
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Dates
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Enumeration Date | 08/21/2008
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Last Update Date | 01/31/2013
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Provider Practice Location Address
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Address Line | 4334 PARKER DR
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City | RIVERDALE
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State | UT
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Zip | 84405-3340
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Country | US
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Telephone | 801-394-7481
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Fax | 801-621-6150
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Provider Business Mailing Address
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Address Line | 4334 PARKER DR
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City | RIVERDALE
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State | UT
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Zip | 84405-3340
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Country | US
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Telephone | 801-394-7481
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Fax | 801-621-6150
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Authorized Official
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Title or Position | CAPTAIN
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Name | MATTHEW G HENNESSY
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Credential |
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Telephone | 801-394-7481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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