Provider Demographics
NPI:1154047090
Name:MOUNTAIN PEAK ASSOCIATES LLC
Entity type:Organization
Organization Name:MOUNTAIN PEAK ASSOCIATES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL SERVICES/COMPL
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILDENBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:RT
Authorized Official - Phone:801-590-2714
Mailing Address - Street 1:132 E 13065 S STE 200
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-5646
Mailing Address - Country:US
Mailing Address - Phone:801-590-2714
Mailing Address - Fax:
Practice Address - Street 1:1140 E SOUTH BOULDER RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-2522
Practice Address - Country:US
Practice Address - Phone:303-854-6408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-12
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies