Organization
RIVERWOODS SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLI CRISP (ACCOUNT MANAGER)
(801) 437-4500
Entity
Organization
Contact information
Practice address
320 RIVER PARK DR STE 125, PROVO, UT 84604-6065
(801) 437-4500
(801) 437-1400
Mailing address
320 RIVER PARK DR STE 125, PROVO, UT 84604-6065
(801) 437-4500
(801) 437-1400
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
2005ASF70230
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103015041101
IHC
UT
01
—
20057023000001
BCBS
UT
01
—
268010
ALTIUS
UT
01
—
34980
HEALTHY U
UT
01
—
920829
DMBA
UT
Enumeration date
06/09/2006
Last updated
07/27/2023
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