Healthcare Provider Details

I. General information

NPI: 1720270275
Provider Name (Legal Business Name): WASATCH HOMELESS HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2007
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 WEST 400 SOUTH
SALT LAKE UT
84101-8410
US

IV. Provider business mailing address

409 W 400 S
SALT LAKE CITY UT
84101-1135
US

V. Phone/Fax

Practice location:
  • Phone: 801-333-8628
  • Fax: 801-433-0153
Mailing address:
  • Phone: 801-333-8628
  • Fax: 801-433-0153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number49490201703
License Number StateUT

VIII. Authorized Official

Name: JANIDA EMERSON
Title or Position: CEO
Credential:
Phone: 801-364-0058