Organization
COUNTY OF SUMMIT
Active
Other names
South Summit Ambulance
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE L FRAZIER (AUDITOR)
(435) 336-3254
Entity
Organization
Contact information
Practice address
210 EAST 400 SOUTH, KAMAS, UT 84036-0266
(435) 783-6276
(435) 783-6277
Mailing address
PO BOX 95970, SOUTH JORDAN, UT 84095-0970
(801) 352-9500
(801) 352-9502
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144259805
—
UT
01
—
590011561
RAILROAD MEDICARE
UT
Enumeration date
07/02/2006
Last updated
04/06/2011
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