Provider Demographics
NPI:1346235496
Name:SANDY CITY CORP
Entity Type:Organization
Organization Name:SANDY CITY CORP
Other - Org Name:SANDY CITY FIRE DEPARTMENT AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENKRANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-568-2936
Mailing Address - Street 1:PO BOX 1099
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84091-1099
Mailing Address - Country:US
Mailing Address - Phone:801-568-2940
Mailing Address - Fax:801-568-7154
Practice Address - Street 1:9070 S. 150 E.
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-2735
Practice Address - Country:US
Practice Address - Phone:801-568-2940
Practice Address - Fax:801-568-7154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-14
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1809L3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
590006711OtherRAILROAD MEDICARE
UT000009012Medicare ID - Type Unspecified