Organization
COUNTY OF SALT LAKE
Active
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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