MEDICARE: CHRISTUS HEALTH UTAH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	2006-NCF-85	UT

General Provider Information

NPI Number	:	1093774218
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTUS HEALTH UTAH

Provider Business Mailing Address
First Line	:	451 BISHOP FEDERAL LN
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84115-2357
Country	:	US
Telephone Number	:	801-487-7557
Fax Number	:	801-487-1112

Provider Business Practice Location Address
First Line	:	451 BISHOP FEDERAL LN
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84115-2357
Country	:	US
Telephone Number	:	801-487-7557
Fax Number	:	801-487-1112

Authorized Official
Title or Position	:	CEO
Name	:	MR. GALEN K EWER
Credential	:
Telephone Number	:	801-487-7557

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	08/22/2020

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