Organization
MEDICOR, LLC
Active
Organization
MEDICOR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD E FROST (OWNER)
(801) 942-5543
Entity
Organization
Contact information
Practice address
2469 FORT UNION BLVD, STE 105, SALT LAKE CITY, UT 84121-3343
(801) 942-5543
(801) 944-4877
Mailing address
3652 BRIGHTON POINT DR, SALT LAKE CITY, UT 84121-5555
(801) 942-5543
(801) 944-4877
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
870454846001
—
UT
Enumeration date
07/07/2005
Last updated
02/22/2012
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