Provider Demographics
NPI:1184193922
Name:LIVING MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:LIVING MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:KAMAL
Authorized Official - Last Name:OKOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-809-6644
Mailing Address - Street 1:4055 S 700 E STE 101F
Mailing Address - Street 2:
Mailing Address - City:MILLCREEK
Mailing Address - State:UT
Mailing Address - Zip Code:84107-2508
Mailing Address - Country:US
Mailing Address - Phone:801-809-6644
Mailing Address - Fax:801-809-6644
Practice Address - Street 1:4055 S 700 E STE 101F
Practice Address - Street 2:
Practice Address - City:MILLCREEK
Practice Address - State:UT
Practice Address - Zip Code:84107-2508
Practice Address - Country:US
Practice Address - Phone:801-809-6644
Practice Address - Fax:801-809-6644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-22
Last Update Date:2021-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies