# CENTRAL UTAH SURGICAL CENTER L.L.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962463950
- **Authorized official:** JILL ANDREWS (ADMINISTRATOR)
- **Authorized official phone:** (801) 374-0354

## Contact information

- **Practice address:** 1067 N 500 W, PROVO, UT 84604-3305
- **Practice address phone:** (801) 374-0354
- **Practice address fax:** (801) 344-8929
- **Mailing address:** PO BOX 271472, SALT LAKE CITY, UT 84127-1472
- **Mailing address phone:** (801) 374-0354
- **Mailing address fax:** (801) 344-8929

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 2004-ASF-725 | UT | Yes |

## Other

- **Enumeration date:** 03/29/2006
- **Last updated:** 04/20/2008