Provider Demographics
NPI:1295845337
Name:UTAH TRANSIT AUTHORITY
Entity Type:Organization
Organization Name:UTAH TRANSIT AUTHORITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FAST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-262-5626
Mailing Address - Street 1:3600 S 700 W
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84119-4122
Mailing Address - Country:US
Mailing Address - Phone:801-262-5626
Mailing Address - Fax:801-287-4614
Practice Address - Street 1:3600 S 700 W
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84119-4122
Practice Address - Country:US
Practice Address - Phone:801-262-5626
Practice Address - Fax:801-287-4614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT347B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347B00000XTransportation ServicesBus
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========001Medicaid