Provider Demographics
NPI:1992969786
Name:UNIVERSITY OF UTAH HOSPITAL
Entity type:Organization
Organization Name:UNIVERSITY OF UTAH HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN INTERN
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAMI
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:WEESE
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:801-941-8740
Mailing Address - Street 1:26N 1900 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84132
Mailing Address - Country:US
Mailing Address - Phone:801-585-2804
Mailing Address - Fax:
Practice Address - Street 1:26 N 1900 E
Practice Address - Street 2:CYSTIC FIBROSIS CENTER
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-0002
Practice Address - Country:US
Practice Address - Phone:801-585-2804
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT53293024408282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital