Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Children |
282NC2000X | A0[7] | Hospital-Children’s (PPS excluded) |
| NPI # | 1154508653 |
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| LBN Legal business name | INTERMOUNTAIN HEALTHCARE | ||||
| Authorized official | DONALD VERNON - (MEDICAL DIRECTOR, PED CRIT CARE) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 01/28/2008 | ||||
| Last updated | 01/28/2008 - About 18 years ago | ||||
| Identifiers |
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