STONE MOUNTAIN SURGICAL, LLC (NPI# 1790280816) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790280816 |
| Entity Type | Organization |
| Organization Name | STONE MOUNTAIN SURGICAL, LLC |
| Practice Address |
6804 S 1300 E Cottonwood Heights UT 84121-2882 |
| Mailing Address |
6905 S 1300 E Ste 161 Midvale UT 84047-1817 |
| Practice Telephone | 8015712295 |
| Practice Fax Number | 8012063770 |
| Mailing Telephone | 8015712295 |
| Mailing Fax Number | 8012063770 |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2018-03-29 |
| Authorized Official Name | MR. BLAKE SEIFERS (OWNER) |
| Authorized Official Telephone | 8015712295 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
UT | Suppliers |
| Street Address |
6804 S 1300 E |
| City | COTTONWOOD HEIGHTS |
| State | UT |
| Zip Code | 84121-2882 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407483522 | Kaitlyn Horne | Behavior Technician | 6910 S. Highland Drive, Cottonwood Heights, UT 84121 | 2020-03-26 |
| 1952936387 | Jared Wells | Behavior Technician | 6910 S Highland Drive, Cottonwood Heights, UT 84121 | 2020-03-05 |
| 1518591874 | Slc Plastic Surgery LLC | Plastic Surgery | 6686 Highland Drive, Cottonwood Heights, UT 84121 | 2020-02-26 |
| 1093273708 | Anna O'hearon | Counselor | New Roads Behavioral Health, 2450 Fort Union Blvd, Cottonwood Heights, UT 84121 | 2019-03-12 |
| 1053883181 | Charles Keller IIi | Pediatrics | 2198 S Yvonne Rd #344, Salt Lake City, UT 84121 | 2018-12-31 |
| 1669964516 | Marissa King | Specialist | 1141 E. 3900 S. Suite 150a, Salt Lake, UT 84121 | 2018-06-05 |
| 1376044313 | Slpd Cottonwood LLC | Dentist | 7167 South Highland Drive, 200, Cottonwood Heights, UT 84121 | 2018-02-26 |
| 1700315462 | Nelson & Tillmann Family Dentistry, PC | Dentist | 5872 S. 900 E. Ste 202, Salt Lake City, UT 84121 | 2017-06-07 |
| 1912430588 | Wasatch Midwifery and Wellness, LLC | Dietitian, Registered | 6440 S Wasatch Blvd, Ste 140, Holladay, UT 84121 | 2017-04-10 |
| 1407308331 | Tina Polgar | Registered Nurse | 6244 Highland Drive, Murray, UT 84121 | 2016-10-26 |
| Find all providers in zip 84121 | ||||
| Taxonomy Code | 332BC3200X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Customized Equipment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699304089 | Goal Pediatric Orthotics LLC | Durable Medical Equipment & Medical Supplies | 917 W 1630 N, Orem, UT 84057-8615 | 2020-04-07 |
| 1487292439 | Portable Walk-in Whirlpool Tub L.L.C. | Durable Medical Equipment & Medical Supplies | 5918 S 350 W, Murray, UT 84107-6981 | 2019-12-19 |
| 1013474303 | Sound Sleep Medical LLC | Durable Medical Equipment & Medical Supplies | 310 E 4500 S Ste 110, Murray, UT 84107-4224 | 2019-02-23 |
| 1437631595 | Spainhower Dental Care PC | Durable Medical Equipment & Medical Supplies | 2112 N Hill Field Rd Ste 2a, Layton, UT 84041-4047 | 2018-09-05 |
| 1487150728 | Sound Sleep Medical LLC | Durable Medical Equipment & Medical Supplies | 640 East 700 South Building 2, St. George, UT 84770 | 2018-04-04 |
| 1790286433 | Sound Sleep Medical LLC | Durable Medical Equipment & Medical Supplies | 1075 N Washington Blvd, Ogden, UT 84404-3605 | 2018-02-27 |
| 1295273548 | United Seating and Mobility LLC | Durable Medical Equipment & Medical Supplies | 2305 S Presidents Drive, Suite D, West Valley City, UT 84120-7342 | 2017-02-07 |
| 1588011688 | Eclipse Mobility, LLC | Durable Medical Equipment & Medical Supplies | 570 E 1700 S, 204, Clearfield, UT 84015-2360 | 2016-05-18 |
| 1902263700 | Jeffrey Anderson | Durable Medical Equipment & Medical Supplies | 420 S 100 E, Farmington, UT 84025-2276 | 2016-01-25 |
| 1851756050 | Compass Limb and Brace LLC | Durable Medical Equipment & Medical Supplies | 1140 36th St., Suite 165, Ogden, UT 84403-2064 | 2015-12-15 |
| Find all providers with the same taxonomy | ||||
| City | COTTONWOOD HEIGHTS |
| Zip Code | 84121 |
Please comment or provide details below to improve the information on STONE MOUNTAIN SURGICAL, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.