Provider Demographics
NPI:1497702922
Name:RGL MEDICAL SERVICES LLC
Entity Type:Organization
Organization Name:RGL MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:LEO
Authorized Official - Suffix:
Authorized Official - Credentials:RT
Authorized Official - Phone:801-568-9895
Mailing Address - Street 1:1561 W 7000 S
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-3556
Mailing Address - Country:US
Mailing Address - Phone:801-568-9895
Mailing Address - Fax:801-352-0400
Practice Address - Street 1:1561 W 7000 S
Practice Address - Street 2:SUITE 102
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84084-3556
Practice Address - Country:US
Practice Address - Phone:801-568-9895
Practice Address - Fax:801-352-0400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-29
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000090751Medicare PIN