Provider Demographics
NPI:1720574130
Name:DIATHRIVE, INC.
Entity Type:Organization
Organization Name:DIATHRIVE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SEEGMILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-894-9816
Mailing Address - Street 1:5120 W AMELIA EARHART DR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84116-2854
Mailing Address - Country:US
Mailing Address - Phone:866-878-7477
Mailing Address - Fax:
Practice Address - Street 1:5120 W AMELIA EARHART DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84116-2854
Practice Address - Country:US
Practice Address - Phone:866-878-7477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-09
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies