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Contact Information

MAUREEN BLACK, RN
5121 S COTTONWOOD ST
IM WOMEN AND CHILDREN ADMINISTRATION 15400-15541
MURRAY, UT84107-5701
 Phone: 801-507-7673
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Women

282NW0100X
Indicates primary specialty

NPI Profile & details for

NPI # 1528431335
Entity Organization
Organization subpart 1 Not specified
Enumeration date 11/03/2015
Last updated 11/03/2015 - About 11 years ago
Identifiers
UT License # 290597-3102
UT Medicaid 942854057
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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