Healthcare Provider Details

I. General information

NPI: 1982691853
Provider Name (Legal Business Name): JDC & ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5278 PINEMONT DR A-120
MURRAY UT
84123-2711
US

IV. Provider business mailing address

5278 PINEMONT DR A-120
MURRAY UT
84123-2711
US

V. Phone/Fax

Practice location:
  • Phone: 801-262-7397
  • Fax: 801-262-8011
Mailing address:
  • Phone: 801-262-7397
  • Fax: 801-262-8011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateUT

VIII. Authorized Official

Name: JEFFEREY L GARDNER
Title or Position: COO
Credential:
Phone: 801-262-7397