Provider Demographics
NPI:1699240648
Name:MERCHANT MANAGEMENT
Entity type:Organization
Organization Name:MERCHANT MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS DEVELOPMENT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WATTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-637-1165
Mailing Address - Street 1:1866 E ORCHARD HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:HOLLADAY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-1786
Mailing Address - Country:US
Mailing Address - Phone:801-637-1165
Mailing Address - Fax:
Practice Address - Street 1:241 HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-6405
Practice Address - Country:US
Practice Address - Phone:801-837-2352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCHANT MANAGEMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-05
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility