Provider Demographics
NPI:1417399957
Name:PARAMOUNT HEALTHCARE, LLC
Entity Type:Organization
Organization Name:PARAMOUNT HEALTHCARE, LLC
Other - Org Name:SILVERPEAK REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:LOBATO
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:801-913-4950
Mailing Address - Street 1:PO BOX 520748
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84152-0748
Mailing Address - Country:US
Mailing Address - Phone:801-913-4950
Mailing Address - Fax:801-880-5398
Practice Address - Street 1:3540 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84115-4435
Practice Address - Country:US
Practice Address - Phone:801-917-9000
Practice Address - Fax:801-383-9992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-25
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT464506Medicare PIN
UT464506Medicare Oscar/Certification