Healthcare Provider Details

I. General information

NPI: 1093763427
Provider Name (Legal Business Name): HEALTH WATCH PROVO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 10/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1485 E 840 N
OREM UT
84097-5486
US

IV. Provider business mailing address

9152 SILVER LAKE DR
CEDAR HILLS UT
84062-8787
US

V. Phone/Fax

Practice location:
  • Phone: 801-225-0599
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number2005-HHA-825
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: KAYE LOPEZ
Title or Position: OWNER
Credential:
Phone: 801-225-0599