Healthcare Provider Details

I. General information

NPI: 1790306629
Provider Name (Legal Business Name): OAKSTEAD NURSING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2020
Last Update Date: 06/11/2020
Certification Date: 06/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1492 W ANTELOPE DR STE 208A
LAYTON UT
84041-1158
US

IV. Provider business mailing address

1492 W ANTELOPE DR STE 208A
LAYTON UT
84041-1158
US

V. Phone/Fax

Practice location:
  • Phone: 805-630-2072
  • Fax: 801-991-6924
Mailing address:
  • Phone: 805-630-2072
  • Fax: 801-991-6924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROBERT GALERIA
Title or Position: OWNER
Credential:
Phone: 805-630-2072