Healthcare Provider Details

I. General information

NPI: 1770665010
Provider Name (Legal Business Name): BURCHCREEK HOMECARE & HOSPICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1496 E 5600 S STE 4
OGDEN UT
84403-4565
US

IV. Provider business mailing address

1496 E 5600 S STE 4
OGDEN UT
84403-4565
US

V. Phone/Fax

Practice location:
  • Phone: 801-452-6066
  • Fax:
Mailing address:
  • Phone: 801-452-6066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JENNIE FRY
Title or Position: ADMINISTRATOR
Credential: MBA
Phone: 801-452-6066