Provo Dialysis Center University of Utah

NPI #1194824201 in Provo, Utah

Provider Information

NPI Number: 1194824201
Entity Type: Organization
Organization Name: Provo Dialysis Center University of Utah
Primary Specialty: Clinic/Center - End-Stage Renal Disease (ESRD) Treatment
Enumeration Date: Sep 22, 2006
Last Updated: May 21, 2014

Practice Location

Address: 1675 N FREEDOM BLVD
City: Provo
State: Utah
ZIP Code: 84604-2540
Phone: (801) 373-0167

Authorized Official

Name: MR. STEVEN L HEMMING
Title: PROGRAM ADMINISTRATOR
Phone: (801) 581-8573

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment — End-Stage Renal Disease (ESRD) Treatment	261QE0700X	Primary

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