Organization
COUNTY OF SALT LAKE
Active
Other names
Salt Lake County Corporation
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA KEERS (FISCAL MANAGER)
(801) 468-2766
Entity
Organization
Contact information
Practice address
1992 S 200 E, SALT LAKE CITY, UT 84115-2459
(801) 468-2454
(801) 468-2838
Mailing address
2001 S STATE ST, S1500, SALT LAKE CITY, UT 84190-2300
(801) 468-2454
(801) 468-2852
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251J00000X
Nursing Care Agency
Primary
346865-3102
UT
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332U00000X
Home Delivered Meals
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000064172
MEDICARE PTAN
UT
01
—
1164579335
NATIONAL PROVIDER IDENTIF
—
Enumeration date
01/03/2007
Last updated
09/16/2008
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