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Acqua Medical Llc

Acqua Medical Llc is a health care provider in Salt Lake City, UT. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 100 N Johnson Mill Rd, Midway, UT 84049-6764, US
Practice Location Phone844-654-3700
Practice Location Fax801-926-1133
Legal Business NameACQUA MEDICAL LLC
NPI ?1427580448
Entity TypeOrganization
Enumeration Date ? Mar 29, 2017
Last Update Date ? Jun 20, 2018
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Acqua Medical Llc

SpecialtySpecializationLicenseLicense State
Psychiatry & NeurologyAddiction Medicine
Family MedicineAddiction Medicine 293281-1205Utah

legacy-id-icon Legacy Provider IDs of Acqua Medical Llc

Provider IdIssuer StateIssuer TypeIssuer
=========UtahOtherEIN

official-icon Authorized Official of Acqua Medical Llc

An authorized official is an appointed official with the legal authority to make changes and/or updates to the Acqua Medical Llc's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official Clint Tolman
Authorized Official Title/PositionADMINISTRATIVE DIRECTOR
Authorized Official Phone Number844-654-3700