Provider Demographics
NPI:1770353740
Name:KIWI KIDS INC
Entity type:Organization
Organization Name:KIWI KIDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR / MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:VAISHALI
Authorized Official - Middle Name:
Authorized Official - Last Name:AGARWAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:385-831-8675
Mailing Address - Street 1:11629 S 700 E STE 125
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-8382
Mailing Address - Country:US
Mailing Address - Phone:385-831-8675
Mailing Address - Fax:
Practice Address - Street 1:11629 S 700 E STE 125
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-8382
Practice Address - Country:US
Practice Address - Phone:385-831-8675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health