Provider Demographics
NPI:1639713993
Name:DESERT ARCH, LLC
Entity Type:Organization
Organization Name:DESERT ARCH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-703-3990
Mailing Address - Street 1:4722 BOUNTIFUL RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-5888
Mailing Address - Country:US
Mailing Address - Phone:801-703-3990
Mailing Address - Fax:801-618-1580
Practice Address - Street 1:4722 BOUNTIFUL RIDGE DR
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-5888
Practice Address - Country:US
Practice Address - Phone:801-703-3990
Practice Address - Fax:801-618-1580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies