Organization
CENTRAL UTAH SURGICAL CENTER L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL ANDREWS (ADMINISTRATOR)
(801) 374-0354
Entity
Organization
Contact information
Practice address
1067 N 500 W, PROVO, UT 84604-3305
(801) 374-0354
(801) 344-8929
Mailing address
PO BOX 271472, SALT LAKE CITY, UT 84127-1472
(801) 374-0354
(801) 344-8929
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
2004-ASF-725
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
87028102805001
BCBS
UT
Enumeration date
03/29/2006
Last updated
04/20/2008
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