Provider Demographics
NPI:1114794575
Name:HSA DEPOT
Entity type:Organization
Organization Name:HSA DEPOT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:OSTERMILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-265-0380
Mailing Address - Street 1:1484 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341-2224
Mailing Address - Country:US
Mailing Address - Phone:435-265-0380
Mailing Address - Fax:435-915-3678
Practice Address - Street 1:1484 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-2224
Practice Address - Country:US
Practice Address - Phone:435-265-0380
Practice Address - Fax:435-915-3678
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIFESTYLE MEDICAL SUPPLY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-06
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies