Provider Demographics
NPI:1235260795
Name:COUNTY OF SALT LAKE
Entity Type:Organization
Organization Name:COUNTY OF SALT LAKE
Other - Org Name:SALT LAKE VALLEY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SALT LAKE COUNTY MAYOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:M
Authorized Official - Last Name:CORROON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-468-2500
Mailing Address - Street 1:2001 S STATE STREET
Mailing Address - Street 2:SUITE S2500 PO BOX 144575
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84114-4575
Mailing Address - Country:US
Mailing Address - Phone:385-468-4114
Mailing Address - Fax:385-468-4106
Practice Address - Street 1:2001 S STATE ST
Practice Address - Street 2:SUITE S2500
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84190-0001
Practice Address - Country:US
Practice Address - Phone:385-468-4114
Practice Address - Fax:385-468-4106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT32338OtherPUBLIC EMP HEALTH PLAN
UT99889OtherHEALTHY U
UT0100488OtherUNITED HEALTHCARE OF UTAH
UT600000920OtherRAILROAD MEDICARE
UT600000920OtherRAILROAD MEDICARE
UT99889OtherHEALTHY U
UT=========012 W2088Medicaid
UT========= PRA06401OtherMOLINA HEALTH CARE
UT=========012Medicaid