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General NPI Number Information
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NPI Number | 1356481337
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Entity Type | Organization
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Legal Business Name | MAJIC REST, INC.
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 08/17/2018
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Provider Practice Location Address
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Address Line | 3540 S MAIN ST
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City | SALT LAKE CITY
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State | UT
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Zip | 84115-4435
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Country | US
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Telephone | 801-281-8688
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Fax | 801-281-4159
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Provider Business Mailing Address
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Address Line | PO BOX 65785
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City | SALT LAKE CITY
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State | UT
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Zip | 84165-0785
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Country | US
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Telephone | 801-281-8688
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Fax | 801-281-4159
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Authorized Official
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Title or Position | EXEC. GEN. MGR.
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Name | MR. J GRYGOTIS
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Credential |
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Telephone | 801-281-8688
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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 | 001467
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License Number State | UT
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