Organization
WASATCH INFUSION SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWIN CHARLES SCHADEWALD III (CEO)
(801) 739-5834
Entity
Organization
Contact information
Practice address
348 E 4500 S, SUITE 220, SALT LAKE CITY, UT 84107-3906
(801) 577-7055
(888) 717-7578
Mailing address
348 E 4500 S, SUITE 220, SALT LAKE CITY, UT 84107-3906
(801) 577-7055
(888) 717-7578
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
149384-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U000074943
PTAN
UT
Enumeration date
10/24/2014
Last updated
10/24/2014
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