Organization
LAKESIDE DIALYSIS CENTER UNIVERSITY OF UTAH
Active
Other names
University of Utah
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN L. HEMMING (DIRECTOR/CEO)
(801) 581-3659
Entity
Organization
Contact information
Practice address
532 S 500 W, BOUNTIFUL, UT 84010-7208
(801) 299-3470
(801) 299-3415
Mailing address
PO BOX 27071, SALT LAKE CITY, UT 84127-7071
(801) 299-3470
(801) 587-9342
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
2004-ESRD-932
UT
Other
Enumeration date
09/22/2006
Last updated
07/11/2014
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