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Organization
CANYONLANDS MEDICAL LC
Active
Organization
CANYONLANDS MEDICAL LC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAR NELSON (PRES)
(801) 393-6333
Entity
Organization
Contact information
Practice address
5790 HARRISON BLVD, STE. 2, SOUTH OGDEN, UT 84403-4325
(801) 393-6333
(801) 394-6333
Mailing address
PO BOX 150193, OGDEN, UT 84415-0193
(801) 393-6333
(801) 394-6333
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
5528522-1703
UT
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
5528522-1703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
870479372003
—
UT
Enumeration date
01/10/2006
Last updated
04/20/2008
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