Organization · Type 2 NPI
Lakeside Dialysis Center University of Utah
End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Bountiful, UT
NPI number
1508965617
Active
Practice location
532 S 500 W
Bountiful, UT 84010-7208
Fax (801) 299-3415
Mailing address
PO Box 27071
Salt Lake City, UT 84127-7071
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary | 261QE0700X | 2004-ESRD-932 (UT) |
End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...
Another provider at this address
Other end-stage renal disease (esrd) treatment clinic/center providers in Bountiful
About NPI 1508965617
Lakeside Dialysis Center University of Utah's National Provider Identifier is 1508965617, issued on Sep 22, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Bountiful, UT. The record was last updated on Jul 11, 2014.