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Organization

MYELOMA CARE DEPARTMENT OF UNIVERSITY OF UTAH

Active
Other names
UUMC - Myeloma Care
Organization subpart
No

Provider details

NPI number
Authorized official
JANELL I MADONNA (DIRECTOR OF CONTRACTING AND PE)
(801) 587-6464
Entity
Organization

Contact information

Practice address
1950 CIRCLE OF HOPE DR, SALT LAKE CITY, UT 84112-5500
(801) 581-2121
Mailing address
PO BOX 413033, SALT LAKE CITY, UT 84141-0001
(801) 581-2121

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
808115200
ID
05
808154300 - MID
ID
01
DN9494
RR MEDICARE
UT
Enumeration date
07/21/2008
Last updated
04/14/2009
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