Healthcare Provider Details

I. General information

NPI: 1891841482
Provider Name (Legal Business Name): PRIMROSE HOSPICE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 02/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

286 N GATEWAY DR STE 101
PROVIDENCE UT
84332-5602
US

IV. Provider business mailing address

286 N GATEWAY DR STE 101
PROVIDENCE UT
84332-5602
US

V. Phone/Fax

Practice location:
  • Phone: 435-787-1369
  • Fax:
Mailing address:
  • Phone: 435-787-1369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number StateUT

VIII. Authorized Official

Name: MR. MARK C STOKES
Title or Position: CEO
Credential:
Phone: 435-787-1369