Provider Demographics
NPI:1821374208
Name:REMEDY MEDICAL, LLC
Entity Type:Organization
Organization Name:REMEDY MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:RIDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-941-9889
Mailing Address - Street 1:2815 W 3825 S
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-6700
Mailing Address - Country:US
Mailing Address - Phone:801-941-9889
Mailing Address - Fax:
Practice Address - Street 1:2815 W 3825 S
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:UT
Practice Address - Zip Code:84401-6700
Practice Address - Country:US
Practice Address - Phone:801-941-9889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8131873-0160332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies