MEDICARE: AT HOME PERSONAL CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency		UT

General Provider Information

NPI Number	:	1083718522
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AT HOME PERSONAL CARE

Provider Business Mailing Address
First Line	:	230 W 200 S STE 2613
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84101-3487
Country	:	US
Telephone Number	:	801-746-5558
Fax Number	:

Provider Business Practice Location Address
First Line	:	230 W 200 S STE 2613
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84101-3487
Country	:	US
Telephone Number	:	801-746-5558
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MISS CHRISTY BUSKIRK
Credential	:
Telephone Number	:	801-746-5558

Provider Enumeration Date	:	09/12/2006
Last Update Date	:	08/22/2020

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Directions to “AT HOME PERSONAL CARE ” Practice Location

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