Provider Demographics
NPI:1598985145
Name:MCT MEDICAL
Entity Type:Organization
Organization Name:MCT MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-569-3033
Mailing Address - Street 1:8821 REDWOOD RD STE D
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-9280
Mailing Address - Country:US
Mailing Address - Phone:801-569-3033
Mailing Address - Fax:801-569-3036
Practice Address - Street 1:8821 REDWOOD RD STE D
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-9280
Practice Address - Country:US
Practice Address - Phone:801-569-3033
Practice Address - Fax:801-569-3036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies