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Organization
INTERMOUNTAIN HEALTHCARE
Active
Organization
INTERMOUNTAIN HEALTHCARE
Active
Other names
Primary Children's Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD VERNON MD (MEDICAL DIRECTOR, PED CRIT CARE)
(801) 662-2427
Entity
Organization
Contact information
Practice address
100 N MEDICAL DR, PCMC, SALT LAKE CITY, UT 84113-1103
(801) 662-2442
(801) 662-2469
Mailing address
100 N MEDICAL DR, PCMC, SALT LAKE CITY, UT 84113-1103
(801) 662-2442
(801) 662-2469
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
218983-4405
UT
Other
Enumeration date
01/28/2008
Last updated
01/28/2008
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