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NPI Code Detail

MEDICARE: LANDMARK REHABILITATION HOSPITAL OF SALT LAKE CITY, LLC

MEDICARE: LANDMARK REHABILITATION HOSPITAL OF SALT LAKE CITY, LLC
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
1283X00000XRehabilitation Hospital

General Provider Information

NPI Number : 1881120756
Entity Type Code : Organization
Provider Name (Legal Business Name) : LANDMARK REHABILITATION HOSPITAL OF SALT LAKE CITY, LLC
Provider Business Mailing Address
First Line : 4252 S BIRKHILL BLVD
Second Line :
City : MURRAY
State : UT
Zip : 84107-5715
Country : US
Telephone Number : 801-268-5400
Fax Number :
Provider Business Practice Location Address
First Line : 4252 S BIRKHILL BLVD
Second Line :
City : MURRAY
State : UT
Zip : 84107-5715
Country : US
Telephone Number : 801-268-5400
Fax Number :
Authorized Official
Title or Position : CORPORATE CEO
Name : SHAWN STRASH
Credential :
Telephone Number : 602-320-7154
Provider Enumeration Date : 05/11/2017
Last Update Date : 05/11/2017

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