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General NPI Number Information
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NPI Number | 1396018545
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Entity Type | Organization
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Legal Business Name | RED ROCK MEDICAL SUPPLY
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Dates
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Enumeration Date | 02/20/2012
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Last Update Date | 09/10/2019
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Provider Practice Location Address
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Address Line | 1880 N 2200 W STE 40
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City | SALT LAKE CITY
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State | UT
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Zip | 84116-4136
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Country | US
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Telephone | 801-886-9700
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Fax | 801-415-9423
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Provider Business Mailing Address
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Address Line | 450 S 900 E STE 100
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City | SALT LAKE CITY
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State | UT
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Zip | 84102-2981
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Country | US
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Telephone | 801-886-9700
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Fax | 801-531-1949
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Authorized Official
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Title or Position | OWNER
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Name | EDDIE NORRIS
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Credential |
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Telephone | 801-485-6166
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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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