EMERGENCY PHYSICIANS INTEGRATED CARE, LLC

Provider Demographics

• NPI: 1578598199
• Name: EMERGENCY PHYSICIANS INTEGRATED CARE, LLC
• Entity Type: Organization
• Organization Name: EMERGENCY PHYSICIANS INTEGRATED CARE, LLC
• Authorized Official - Title/Position: CEO
• Authorized Official - First Name: ROBERT
• Authorized Official - Last Name: PARKER
• Authorized Official - Suffix: JR
• Authorized Official - Phone: 801-463-7415
• Mailing Address - Street 1: 333 NORTH 300 WEST
• Mailing Address - City: SALT LAKE CITY
• Mailing Address - State: UT
• Mailing Address - Zip Code: 84103-1215
• Mailing Address - Country: US
• Mailing Address - Phone: 801-463-7415
• Practice Address - Street 1: 333 N 300 W
• Practice Address - City: SALT LAKE CITY
• Practice Address - State: UT
• Practice Address - Zip Code: 84103-1215
• Practice Address - Country: US
• Practice Address - Phone: 801-463-7415
• Practice Address - Fax: 801-463-7341
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-07-12
• Last Update Date: 2022-07-21

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	207P00000X	Allopathic & Osteopathic Physicians	Emergency Medicine		Group - Multi-Specialty
No	207PE0004X	Allopathic & Osteopathic Physicians	Emergency Medicine	Emergency Medical Services	Group - Multi-Specialty
No	207PE0005X	Allopathic & Osteopathic Physicians	Emergency Medicine	Undersea and Hyperbaric Medicine	Group - Multi-Specialty
No	208M00000X	Allopathic & Osteopathic Physicians	Hospitalist		Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
UT	1578598199	Medicaid
UT	GC6996	Other	RAILROAD
UT	=========006	Medicaid
UT	=========037	Medicaid
UT	=========010	Medicaid
UT	=========023	Medicaid
UT	=========001	Medicaid
UT	=========041	Medicaid
UT	=========054	Medicaid
UT	1578598199	Medicaid
UT	=========001	Medicaid
UT	000055671	Medicare PIN
UT	=========037	Medicaid
UT	=========010	Medicaid
UT	000057861	Medicare PIN
UT	=========041	Medicaid