Organization
RIVERDALE CITY UTAH
Active
Other names
Riverdale City Corporation
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW G HENNESSY (CAPTAIN)
(801) 394-7481
Entity
Organization
Contact information
Practice address
4334 PARKER DR, RIVERDALE, UT 84405-3340
(801) 394-7481
(801) 621-6150
Mailing address
4334 PARKER DR, RIVERDALE, UT 84405-3340
(801) 394-7481
(801) 621-6150
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00759219
RAILROAD MEDICARE
UT
Enumeration date
08/21/2008
Last updated
01/31/2013
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