Organization
INTERMOUNTAIN HEALTHCARE
Active
Other names
Primary Children's Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD VERNON MD (MEDICAL DIRECTOR, PED CRIT CARE)
(801) 662-2427
Entity
Organization
Contact information
Practice address
100 N MEDICAL DR, PCMC, SALT LAKE CITY, UT 84113-1103
(801) 662-2442
(801) 662-2469
Mailing address
100 N MEDICAL DR, PCMC, SALT LAKE CITY, UT 84113-1103
(801) 662-2442
(801) 662-2469
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
218983-4405
UT
Other
Enumeration date
01/28/2008
Last updated
01/28/2008
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