Provider Demographics
NPI:1235935271
Name:TIMBER PEAKS MEDICAL LLC
Entity type:Organization
Organization Name:TIMBER PEAKS MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-984-8044
Mailing Address - Street 1:10808 S RIVER FRONT PKWY STE 327
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-5136
Mailing Address - Country:US
Mailing Address - Phone:801-824-0672
Mailing Address - Fax:
Practice Address - Street 1:10808 S RIVER FRONT PKWY STE 327
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-5136
Practice Address - Country:US
Practice Address - Phone:801-984-8044
Practice Address - Fax:801-984-4583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-20
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies