Organization
MOUNTAIN MEDICAL SYSTEMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY ANDERSON (OWNER)
(801) 663-6015
Entity
Organization
Contact information
Practice address
563 W 500 S STE 245, BOUNTIFUL, UT 84010-8290
(801) 663-6015
(435) 602-1105
Mailing address
PO BOX 1687, BOUNTIFUL, UT 84011-1687
(801) 663-6015
(435) 602-1105
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122566261714
UTAH DEPARTMENT OF COMMERCE DIVISION OF OCCUPATIONAL AND PERSONAL LICENSING
UT
Enumeration date
02/03/2016
Last updated
01/25/2022
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