Healthcare Provider Details

I. General information

NPI: 1104138205
Provider Name (Legal Business Name): VITALCARE HOME HEALTH AND HOSPICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2010
Last Update Date: 07/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1493 N 150 W
BOUNTIFUL UT
84010-5950
US

IV. Provider business mailing address

1493 N 150 W
BOUNTIFUL UT
84010-5950
US

V. Phone/Fax

Practice location:
  • Phone: 801-719-7963
  • Fax:
Mailing address:
  • Phone: 801-719-7963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number StateUT

VIII. Authorized Official

Name: CONNORIE MURRAY
Title or Position: MEMBER
Credential:
Phone: 801-719-7963