MEDICARE: PLEASANT VIEW DIALYSIS

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	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number	:	1609058528
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLEASANT VIEW DIALYSIS

Provider Business Mailing Address
First Line	:	PO BOX 27071
Second Line	:
City	:	SLC
State	:	UT
Zip	:	84127-0071
Country	:	US
Telephone Number	:	801-581-8578
Fax Number	:	801-581-4750

Provider Business Practice Location Address
First Line	:	2715 N HWY 89
Second Line	:
City	:	PLEASANT VIEW
State	:	UT
Zip	:	84414
Country	:	US
Telephone Number	:	801-581-8578
Fax Number	:	801-581-4750

Authorized Official
Title or Position	:	PROGRAM ADMINISTRATOR
Name	:	MR. STEVEN L. HEMMING
Credential	:
Telephone Number	:	801-581-8573

Provider Enumeration Date	:	12/03/2007
Last Update Date	:	05/21/2014

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Practice Location Address:

268 W 4050 N
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Practice Phone: 801-643-3506
Practice Fax:

Directions to “PLEASANT VIEW DIALYSIS ” Practice Location

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