Healthcare Provider Details

I. General information

NPI: 1376578708
Provider Name (Legal Business Name): ACCESS HOSPICE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 05/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74 W 100 N
LOGAN UT
84321-4506
US

IV. Provider business mailing address

74 W 100 N
LOGAN UT
84321-4506
US

V. Phone/Fax

Practice location:
  • Phone: 435-755-6599
  • Fax: 435-755-6548
Mailing address:
  • Phone: 435-755-6599
  • Fax: 435-755-6548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number2005-HOSPICE-67235
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. CATHY TARBET
Title or Position: ADMINISTRATOR
Credential:
Phone: 435-755-6599