Provider Demographics
NPI:1689809378
Name:UNIVERSITY OF UTAH HOSPITAL AND CLINICS
Entity Type:Organization
Organization Name:UNIVERSITY OF UTAH HOSPITAL AND CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:EDUARDO
Authorized Official - Last Name:DE AMORIM FILHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-842-1035
Mailing Address - Street 1:543 S 900 E APT A8
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-2974
Mailing Address - Country:US
Mailing Address - Phone:801-842-1035
Mailing Address - Fax:
Practice Address - Street 1:30 NORTH1900 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-0001
Practice Address - Country:US
Practice Address - Phone:801-581-7304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-25
Last Update Date:2009-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital