Provider Demographics
NPI:1710273297
Name:HEALTHTRUST UTAH MGMT SERVICES, INC
Entity Type:Organization
Organization Name:HEALTHTRUST UTAH MGMT SERVICES, INC
Other - Org Name:MOUNTAINSTAR PROFESSIONAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIVISION CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:JODY
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-568-5977
Mailing Address - Street 1:PO BOX 271220
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-1220
Mailing Address - Country:US
Mailing Address - Phone:801-736-0720
Mailing Address - Fax:801-366-9883
Practice Address - Street 1:6985 UNION PARK CTR
Practice Address - Street 2:STE 500
Practice Address - City:COTTONWOOD HEIGHTS
Practice Address - State:UT
Practice Address - Zip Code:84047-4177
Practice Address - Country:US
Practice Address - Phone:801-568-5977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty