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Organization
CANYONLANDS MEDICAL LC
Active
Organization
CANYONLANDS MEDICAL LC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EARLE SMITH GREGORY (OPERATIONS)
(435) 634-7625
Entity
Organization
Contact information
Practice address
285 W TABERNACLE ST, STE 101, ST GEORGE, UT 84770-3385
(435) 634-7625
(435) 634-0716
Mailing address
285 W TABERNACLE ST, STE 101, ST GEORGE, UT 84770-3385
(435) 634-7625
(435) 634-0716
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
5528522-1703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5528522-1703
PHARMACY NUMBER
UT
Enumeration date
06/17/2005
Last updated
08/22/2020
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