Healthcare Provider Details

I. General information

NPI: 1902855083
Provider Name (Legal Business Name): COMMUNITY NURSING SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 09/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 S CARBON AVE
PRICE UT
84501-3227
US

IV. Provider business mailing address

2830 S REDWOOD RD SUITE A
WEST VALLEY CITY UT
84119-5625
US

V. Phone/Fax

Practice location:
  • Phone: 435-613-8887
  • Fax: 435-613-8890
Mailing address:
  • Phone: 801-233-6100
  • Fax: 801-233-6110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number2015-HOSPICE-416
License Number StateUT

VIII. Authorized Official

Name: MR. BRENT D JONES
Title or Position: PRESIDENT & CEO
Credential:
Phone: 801-233-6100