Provider Demographics
NPI:1467492892
Name:OQUIRRH ARTIFICIAL KIDNEY CENTER LLC
Entity type:Organization
Organization Name:OQUIRRH ARTIFICIAL KIDNEY CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLANTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-699-9000
Mailing Address - Street 1:5320 S 2700 W
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84129-1524
Mailing Address - Country:US
Mailing Address - Phone:801-982-9726
Mailing Address - Fax:801-982-9727
Practice Address - Street 1:5320 S 2700 W
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84129-1524
Practice Address - Country:US
Practice Address - Phone:801-982-9726
Practice Address - Fax:801-982-9727
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-07
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========001OtherSELECT HEALTH
UT=========001Medicaid
UT=========001Medicaid