Organization · NPI-2
Anthem Dialysis LLC
Technician, Other, Renal Dialysis · Kaysville, UT
NPI number1609353994
StatusActive
Last updated in NPPESMar 14, 2022
Details
- NPI
- 1609353994
- Entity type
- Organization (NPI-2)
- Legal business name
- Anthem Dialysis LLC
- Organization subpart
- No
- Enumeration date
- Jul 19, 2018
- Certification date
- Mar 14, 2022
- Last updated
- Mar 14, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2472R0900X | Technician, Other, Renal Dialysis | – | – | Yes |
Practice location
1213 Flint Meadow Dr Ste 1bKaysville, UT 84037-6833
Phone 385-420-7500 · Fax 385-420-7501
Mailing address
942 Francis CirKaysville, UT 84037-9661
Phone 801-917-9000
Authorized official
Mark Flinders
Owner/Ceo
8019179000
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