Ebrainmd, Llc

LBN: Ebrainmd, Llc
Ebrainmd, Llc is an health care organization with primary practice located at 3401 S Highway 89 , Bountiful UT 84010-8517. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Ebrainmd, Llc can be contacted via phone (801) 295-2438, or through Clyde, Brent Lee via phone (801) 295-2438.

Contact Information

Primary practice address
3401 S Highway 89 Bountiful UT 84010-8517
Phone: (801) 295-2438
Fax: (800) 558-1912
Website:
Map and Directions
Authorized official contact:
Name: Clyde, Brent Lee Doctor of Medicine (MD)
Phone: (801) 295-2438

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 6555A Wyoming

Profile Details

NPI number 1811167547
LBN Legal business name Ebrainmd, Llc
DBA Doing business as
Authorized official Clyde, Brent Lee Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 10th, 2008
Last updated Apr 14th, 2016 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811167547 NPPES
Wyoming MEDICAID 117443600

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