1518907831 NPI number — UNIVERSITY RADIATION ONCOLOGISTS

Table of content: (NPI 1518907831)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518907831 NPI number — UNIVERSITY RADIATION ONCOLOGISTS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY RADIATION ONCOLOGISTS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518907831
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/06/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 413031
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALT LAKE CITY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84141-3031
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-236-7747
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1950 EAST CIRCLE OF HOPE
Provider Second Line Business Practice Location Address:
STE. 1570
Provider Business Practice Location Address City Name:
SALT LAKE CITY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84112-5550
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-581-8793
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SHRIEVE
Authorized Official First Name:
DENNIS
Authorized Official Middle Name:
C
Authorized Official Title or Position:
DEPARTMENT CHAIR
Authorized Official Telephone Number:
801-581-8793

Provider Taxonomy Codes

  • Taxonomy code: 2085R0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2085R0203X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CQ2420 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com