Provider Demographics
NPI:1508549049
Name:NAT-SU HEALTH CARE LLC
Entity Type:Organization
Organization Name:NAT-SU HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BRENNAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:385-529-8735
Mailing Address - Street 1:1929 NORTH AARON DROVE
Mailing Address - Street 2:STE I
Mailing Address - City:TOOELE
Mailing Address - State:UT
Mailing Address - Zip Code:84074-8112
Mailing Address - Country:US
Mailing Address - Phone:435-850-1823
Mailing Address - Fax:435-850-1911
Practice Address - Street 1:1929 NORTH AARON DROVE
Practice Address - Street 2:STE I
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074-8112
Practice Address - Country:US
Practice Address - Phone:435-850-1823
Practice Address - Fax:435-850-1911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center