Provider Demographics
NPI:1932278975
Name:WEST VALLEY CITY
Entity Type:Organization
Organization Name:WEST VALLEY CITY
Other - Org Name:WEST VALLEY AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CITY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:T
Authorized Official - Last Name:PYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-963-3201
Mailing Address - Street 1:3600 CONSTITUTION BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84119-3720
Mailing Address - Country:US
Mailing Address - Phone:801-966-3600
Mailing Address - Fax:
Practice Address - Street 1:3600 CONSTITUTION BLVD
Practice Address - Street 2:
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84119-3720
Practice Address - Country:US
Practice Address - Phone:801-966-3600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1865L341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT610811000OtherFEDERAL DIV. OF LABOR
UT=========001Medicaid
UTP00345644Medicare PIN
UT610811000OtherFEDERAL DIV. OF LABOR