Organization
YELLOWSTONE DIALYSIS CENTER
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
1165 SUMMERS DR, REXBURG, ID 83440-5224
(208) 656-0378
Mailing address
PO BOX 27071, SALT LAKE CITY, UT 84127-0071
(801) 581-8578
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
IDAHO DOESNT ISSUE
ID
Other
Enumeration date
09/22/2006
Last updated
09/11/2007
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