Organization
INTERMOUNTAIN HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MANDI TANNER RN, BSN (NURSE MANAGER)
(801) 387-5528
Entity
Organization
Contact information
Practice address
821 EDGEWOOD DR, OGDEN, UT 84403-4233
(801) 387-2800
Mailing address
821 EDGEWOOD DR, OGDEN, UT 84403-4233
(801) 387-2800
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
5043959-4405
UT
Other
Enumeration date
10/18/2016
Last updated
10/18/2016
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