MEDICARE: RETIREMENT LIVING, INC.

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	291U00000X	Clinical Medical Laboratory	46D1005752	UT

General Provider Information

NPI Number	:	1871740225
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RETIREMENT LIVING, INC.

Provider Business Mailing Address
First Line	:	2011 W 4700 S
Second Line	:
City	:	TAYLORSVILLE
State	:	UT
Zip	:	84118-1107
Country	:	US
Telephone Number	:	801-966-4286
Fax Number	:

Provider Business Practice Location Address
First Line	:	2011 W 4700 S
Second Line	:
City	:	TAYLORSVILLE
State	:	UT
Zip	:	84118-1107
Country	:	US
Telephone Number	:	801-966-4286
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. GARY TAYLOR
Credential	:
Telephone Number	:	801-966-4286

Provider Enumeration Date	:	08/27/2008
Last Update Date	:	08/27/2008

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Directions to “RETIREMENT LIVING, INC. ” Practice Location

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