WASATCH VASCULAR CENTER ASC LLC (NPI# 1184245169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184245169 |
| Entity Type | Organization |
| Organization Name | WASATCH VASCULAR CENTER ASC LLC |
| Practice Address |
3702 S State St Salt Lake City UT 84115-5078 |
| Mailing Address |
40 Valley Stream Pkwy Ste 100 Malvern PA 19355-1407 |
| Practice Telephone | 8012810027 |
| Mailing Telephone | 6106448900 |
| Mailing Fax Number | 4849240053 |
| Enumeration Date | 2020-05-01 |
| Last Update Date | 2020-09-14 |
| Authorized Official Name | GREGG MILLER (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 6106448900 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| Street Address |
3702 S STATE ST |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84115-5078 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114585841 | Donner Anne Schweitzer | Nurse Practitioner | 3702 S State St, Salt Lake City, UT 84115-5078 | 2019-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396344198 | Shannon Ballinger | Clinic/Center | 1470 400 W, Salt Lake City, UT 84115 | 2020-10-22 |
| 1992346704 | Anicka Inc | Clinic/Center | 3195 South Main St, Ste 260, South Salt Lake, UT 84115 | 2019-10-02 |
| 1083177505 | Vitor Gabriel Giuliani Alcantara Carioca | Specialist/Technologist | 1850 South Campus Drive, Salt Lake City, UT 84115 | 2019-04-11 |
| 1427528371 | Samuel James Leonhart | Behavior Technician | 354 East Coatsville Drive, Salt Lake City, UT 84115 | 2018-12-04 |
| 1093228645 | Eco Pharmacy LLC | Pharmacy | 3702 S State Street Suite 115, South Salt Lake City, UT 84115 | 2017-11-06 |
| 1568973055 | Eco Apothecary LLC | Pharmacy | 3701 S State Street Suite 114, South Salt Lake City, UT 84115 | 2017-10-24 |
| 1548780455 | Kelly Lund | Case Manager/Care Coordinator | 447 W. Bearcat Dr., Salt Lake City, UT 84115 | 2017-06-21 |
| 1104271238 | The Church of Philadelphia Inc. | Community/Behavioral Health | 2358 South Main Street, Salt Lake City, UT 84115 | 2016-04-26 |
| 1710368626 | Jennifer Swanhild Edwards | Counselor | 140 W 2100 S Ste 244, Salt Lake City, UT 84115 | 2015-06-16 |
| 1508247065 | John Mcguire | Health Educator | 1370 S. West Temple, Salt Lake City, UT 84115 | 2015-06-10 |
| Find all providers in zip 84115 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639704208 | Salt Lake Surgery Center, LLC | Clinic/Center | 1046 E 100 S Ste D, Salt Lake City, UT 84102-1520 | 2020-03-04 |
| 1952720674 | Bountiful Surgery Center, LLC | Clinic/Center | 6360 S 3000 E Ste 320, Salt Lake City, UT 84121-6932 | 2014-04-09 |
| 1932407277 | Stephen H Bennett Md PC | Clinic/Center | 1045 E 3900 S Ste 201, Salt Lake City, UT 84124-1192 | 2011-03-10 |
| 1568644771 | Physicians Service Group, Inc. | Clinic/Center | 7369 East 2223 South, Salt Lake City, UT 84109 | 2007-11-29 |
| 1780885442 | Lyssa Inc | Clinic/Center | 530 E 500 S, Salt Lake City, UT 84102-2746 | 2007-05-30 |
| 1790906204 | Ear, Nose & Throat Surgery Center of Utah LLC | Clinic/Center | 22 S 900 E Ste 2, Salt Lake City, UT 84102-1307 | 2007-05-01 |
| 1164647707 | Ihc Health Services, Inc. | Clinic/Center | 359 8th Ave, Salt Lake City, UT 84103-2895 | 2007-04-17 |
| 1922148063 | The Surgery Center At Salt Lake Regional, L.L.C. | Clinic/Center | 82 South 1100 East, Suite 200, Salt Lake City, UT 84102 | 2007-02-07 |
| 1881701290 | Wasatch Endoscopy Center Ltd | Clinic/Center | 1220 E 3900 S Ste 1b, Salt Lake City, UT 84124-1327 | 2006-08-23 |
| 1609896216 | Salt Lake Endoscopy Center | Clinic/Center | 24 S 1100 E Ste 103, Salt Lake City, UT 84102-1592 | 2006-07-20 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84115 |
Please comment or provide details below to improve the information on WASATCH VASCULAR CENTER ASC LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.