Provider Demographics
NPI:1902159403
Name:DMEZ LLC
Entity Type:Organization
Organization Name:DMEZ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:QUINN
Authorized Official - Middle Name:
Authorized Official - Last Name:BEARDALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-671-1478
Mailing Address - Street 1:1275 S 800 E
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-7232
Mailing Address - Country:US
Mailing Address - Phone:801-671-1478
Mailing Address - Fax:
Practice Address - Street 1:471 E 1000 S STE C
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:UT
Practice Address - Zip Code:84062-3694
Practice Address - Country:US
Practice Address - Phone:801-225-4418
Practice Address - Fax:855-228-4222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-22
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2012-27605332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies