Provider Demographics
NPI:1366747495
Name:PECTUS SERVICES OF UTAH
Entity type:Organization
Organization Name:PECTUS SERVICES OF UTAH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:PORCELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-732-8876
Mailing Address - Street 1:96 BELMOHR ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-2202
Mailing Address - Country:US
Mailing Address - Phone:877-732-8876
Mailing Address - Fax:973-488-7185
Practice Address - Street 1:877 E VINE ST
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-6515
Practice Address - Country:US
Practice Address - Phone:877-732-8876
Practice Address - Fax:973-488-7185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-21
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment