NPI 1003915513

Bonneville Dialysis Center

Organisation End-Stage Renal Disease (ESRD) Treatment Clinic/Center Ogden, UT

Practice location

Address: 5575 S 500 E, Ogden, UT 84405-6907
Phone: (801) 479-0351
Fax: (801) 476-1766
Mailing address: PO Box 27071, Salt Lake City, UT 84127-0071

Authorised official

Name: Steven L Hemming
Title: Program Administrator
Phone: (801) 581-8573

Registered specialties

End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QE0700X Licence 2004-ESRD-389 (UT)

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Registry record

NPI: 1003915513
Entity type: Organization
NPI issued: 21 Sep 2006
Record last updated: 11 Sep 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.