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General NPI Number Information
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NPI Number | 1275825689
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Entity Type | Organization
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Legal Business Name | DURAMED, LC
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Dates
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Enumeration Date | 05/04/2011
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Last Update Date | 05/04/2011
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Provider Practice Location Address
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Address Line | 1914 E 9400 S # 438
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City | SANDY
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State | UT
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Zip | 84093-3002
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Country | US
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Telephone | 801-930-5179
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Fax | 801-930-5197
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Provider Business Mailing Address
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Address Line | 1914 E 9400 S # 438
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City | SANDY
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State | UT
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Zip | 84093-3002
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Country | US
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Telephone | 801-930-5179
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Fax | 801-930-5197
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. TRACY J CARLSON
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Credential |
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Telephone | 801-930-5179
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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