Healthcare Provider Details

I. General information

NPI: 1619280286
Provider Name (Legal Business Name): FOUNDERS HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2010
Last Update Date: 08/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

664 W CONFLUENCE AVE
MURRAY UT
84123
US

IV. Provider business mailing address

PO BOX 40700
MESA AZ
85274-0700
US

V. Phone/Fax

Practice location:
  • Phone: 801-316-4215
  • Fax: 801-316-4217
Mailing address:
  • Phone: 480-446-9010
  • Fax: 480-993-2033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number13019580-004-STC
License Number StateUT

VIII. Authorized Official

Name: WILLIAM KEYS
Title or Position: CEO
Credential:
Phone: 480-446-9010