Organization
PROVO DIALYSIS CENTER UNIVERSITY OF UTAH
Active
Other names
University of Utah
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN L HEMMING (PROGRAM ADMINISTRATOR)
(801) 581-8573
Entity
Organization
Contact information
Practice address
1675 N FREEDOM BLVD, PROVO, UT 84604-2540
(801) 373-0167
(801) 374-1989
Mailing address
PO BOX 27071, SALT LAKE CITY, UT 84127-0071
(801) 581-8578
(801) 374-1989
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
2004-ESRD-228
UT
Other
Enumeration date
09/22/2006
Last updated
05/21/2014
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