Provider Demographics
NPI:1215120803
Name:UNIVERSITY OF UTAH HOSPITAL
Entity type:Organization
Organization Name:UNIVERSITY OF UTAH HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIVISION CHIEF
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:PAINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-581-7806
Mailing Address - Street 1:26 N 1900 E
Mailing Address - Street 2:ROOM 701
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84132-0002
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:26 N 1900 E
Practice Address - Street 2:ROOM 701
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-0008
Practice Address - Country:US
Practice Address - Phone:801-581-7806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital