Pediatric Cardiology Department Of University Of Utah
LBN: Pediatric Cardiology Department Of University Of Utah
Pediatric Cardiology Department Of University Of Utah is an health care organization with primary practice located at 100 Mario Capecchi Dr , Salt Lake City UT 84113-1103. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Cardiology. Allopathic & Osteopathic Physicians / Pediatric Cardiology is the primary health care specialty.
Pediatric Cardiology Department Of University Of Utah can be contacted via phone (801) 662-5400, or through Clark, Edward B via phone (801) 587-7400.
Contact Information
Primary practice address
100 Mario Capecchi Dr
Salt Lake City UT 84113-1103
Phone: (801) 662-5400
Fax: (801) 662-5404
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ||
| Allopathic & Osteopathic Physicians / Pediatric Cardiology | 2080P0202X |
Profile Details
| NPI number | 1114096195 |
|---|---|
| LBN Legal business name | Pediatric Cardiology Department Of University Of Utah |
| DBA Doing business as | |
| Authorized official | Clark, Edward B Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 6th, 2006 |
| Last updated | Sep 15th, 2009 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114096195 | NPPES |
| Wyoming | MEDICAID | 121313000 | |
| Wyoming | MEDICAID | 200817950A | |
| Wyoming | MEDICAID | 100507101 | |
| Wyoming | MEDICAID | 22001832 | |
| Wyoming | MEDICAID | 807148600 | |
| Wyoming | MEDICAID | 200065910A |
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