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General NPI Number Information
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NPI Number | 1598910853
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Entity Type | Organization
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Legal Business Name | DESERT MEDICAL, LLC
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Dates
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Enumeration Date | 11/29/2008
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Last Update Date | 06/22/2010
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Provider Practice Location Address
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Address Line | 25 N 400 W SUITE 1
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City | NORTH SALT LAKE
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State | UT
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Zip | 84054-2778
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Country | US
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Telephone | 801-294-4084
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Fax | 888-825-3019
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Provider Business Mailing Address
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Address Line | 25 N 400 W SUITE 1
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City | NORTH SALT LAKE
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State | UT
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Zip | 84054-2778
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Country | US
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Telephone | 801-294-4084
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Fax | 888-825-3019
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Authorized Official
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Title or Position | MANAGER
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Name | MR. EVERT ANDERS COOK
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Credential |
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Telephone | 801-294-4084
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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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