Provider Demographics
NPI:1689605842
Name:PRAXAIR HEALTHCARE SERVICES, INC.
Entity Type:Organization
Organization Name:PRAXAIR HEALTHCARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:KALTRIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-837-2330
Mailing Address - Street 1:203 E 6100 S
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-7302
Mailing Address - Country:US
Mailing Address - Phone:801-261-7139
Mailing Address - Fax:801-288-5906
Practice Address - Street 1:1509 S 270 E
Practice Address - Street 2:SUITE 9
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-2297
Practice Address - Country:US
Practice Address - Phone:435-673-3250
Practice Address - Fax:409-654-2068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100500837Medicaid
UT1689605842Medicaid
UT1689605842Medicaid
4433300001Medicare NSC