Provider Demographics
NPI:1922148063
Name:THE SURGERY CENTER AT SALT LAKE REGIONAL, L.L.C.
Entity Type:Organization
Organization Name:THE SURGERY CENTER AT SALT LAKE REGIONAL, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CHAIRPERSON
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:MINTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-478-0010
Mailing Address - Street 1:82 SOUTH 1100 EAST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102
Mailing Address - Country:US
Mailing Address - Phone:760-668-0831
Mailing Address - Fax:
Practice Address - Street 1:82 SOUTH 1100 EAST
Practice Address - Street 2:SUITE 200
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102
Practice Address - Country:US
Practice Address - Phone:760-668-0831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical