Healthcare Provider Details

I. General information

NPI: 1124441993
Provider Name (Legal Business Name): UTAH HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2014
Last Update Date: 04/01/2020
Certification Date: 04/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5320 S 900 E STE 280
MURRAY UT
84117-7244
US

IV. Provider business mailing address

9480 S UNION SQ STE 201
SANDY UT
84070-3466
US

V. Phone/Fax

Practice location:
  • Phone: 801-559-3999
  • Fax: 801-559-3997
Mailing address:
  • Phone: 801-559-3999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number2014-HHA-UT000629
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number2014-HHA-UT000629
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number2014-HHA-UT000629
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number2014-HHA-UT000629
License Number StateUT
# 5
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number2014-PCA-UT000628
License Number StateUT

VIII. Authorized Official

Name: TAMMARA BROWN
Title or Position: OWNER
Credential:
Phone: 801-559-3999