Provider Demographics
NPI:1902476120
Name:HEALTHCARE PI
Entity Type:Organization
Organization Name:HEALTHCARE PI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTHCARE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:LIRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-755-7181
Mailing Address - Street 1:1515 E FORT UNION BLVD
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD HEIGHTS
Mailing Address - State:UT
Mailing Address - Zip Code:84121-2855
Mailing Address - Country:US
Mailing Address - Phone:801-478-0770
Mailing Address - Fax:801-478-0779
Practice Address - Street 1:1515 E FORT UNION BLVD
Practice Address - Street 2:
Practice Address - City:COTTONWOOD HEIGHTS
Practice Address - State:UT
Practice Address - Zip Code:84121-2855
Practice Address - Country:US
Practice Address - Phone:801-478-0770
Practice Address - Fax:801-478-0779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage