NPI 1760810337

Intermountain Healthcare

Organisation Health Maintenance Organization Salt Lake City, UT

Practice location

Address: 324 E 10th Ave STE 178, Salt Lake City, UT 84103-2885
Phone: (801) 408-8500

Authorised official

Name: Gudrun Ulrike Mirin
Title: Clinical Social Worker
Phone: (801) 408-8500

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence 932611213501 (UT)

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Registry record

NPI: 1760810337
Entity type: Organization
NPI issued: 17 Oct 2013
Record last updated: 17 Oct 2013

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.