Healthcare Provider Details

I. General information

NPI: 1467487785
Provider Name (Legal Business Name): FRONTIER LEASING MANAGEMENT LC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 10/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

383 W VINE ST STE 300
MURRAY UT
84123-4745
US

IV. Provider business mailing address

6271 DIXIE DR STE 200
WEST JORDAN UT
84084-1000
US

V. Phone/Fax

Practice location:
  • Phone: 800-486-2186
  • Fax: 801-233-6110
Mailing address:
  • Phone: 801-967-9207
  • Fax: 801-967-9397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number5821673
License Number StateUT

VIII. Authorized Official

Name: MR. BRENT D JONES
Title or Position: CEO
Credential: MBA
Phone: 801-589-9311