Organization
RIDGELINE ENDOSCOPY CENTER L.C.
Active
Other names
Ridgeline Endoscopy Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN LOWE M.D. (GENERAL PARTNER)
(801) 475-5400
Entity
Organization
Contact information
Practice address
6028 S RIDGELINE DR, SUITE 100, SOUTH OGDEN, UT 84405-6914
(801) 475-4988
(801) 475-4948
Mailing address
6028 S RIDGELINE DR, SUITE 100, SOUTH OGDEN, UT 84405-6914
(801) 475-4988
(801) 475-4948
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
2004-ASF-9993
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49004666
RAILROAD MEDICARE
—
05
—
876047546005
—
UT
Enumeration date
11/28/2005
Last updated
08/22/2020
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