Provider Demographics
NPI:1992978340
Name:C3INC
Entity type:Organization
Organization Name:C3INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CORY
Authorized Official - Middle Name:
Authorized Official - Last Name:LUKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-260-9095
Mailing Address - Street 1:6770 S 900 E STE 302
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-1709
Mailing Address - Country:US
Mailing Address - Phone:801-260-9095
Mailing Address - Fax:
Practice Address - Street 1:6770 S 900 E STE 302
Practice Address - Street 2:
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-1709
Practice Address - Country:US
Practice Address - Phone:801-260-9095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies