Organization
INTERMOUNTAIN PEDIATRIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN HARRIS (OFFICE MANAGER)
(801) 355-4316
Entity
Organization
Contact information
Practice address
508 E SOUTH TEMPLE, SUITE 310, SALT LAKE CITY, UT 84102-1013
(801) 355-4316
(801) 355-6267
Mailing address
508 E SOUTH TEMPLE, SUITE 310, SALT LAKE CITY, UT 84102-1013
(801) 355-4316
(801) 355-6267
Taxonomy
Speciality
Code
Description
License number
State
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
Primary
19920633
UT
Other
Enumeration date
05/21/2007
Last updated
08/22/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up