| Organization Name: | MOUNTAINWEST SURGICAL CENTER LLC |
| NPI Number: | 1124079843 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRIAN BERG (ADMINISTRATOR) |
| Mailing Address: | 1551 S Renaissance Towne Dr Suite 200 Bountiful |
| State: | UT US |
| Postal Code: | 840107667 |
| Phone Number: | 8013831111 |
| Fax Number: | 8013831115 |
| NPI Enumeration Date: | 05/15/2006 |
| NPI Last Update Date: | 10/28/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 2006-31532 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |